Comparison of Airway Ultrasound and Conventional Methods in Airway Management: Effectiveness and Temporal Efficiency in Traumatic Patients in Emergency Department

Introduction: Effective airway management is critical in trauma care, particularly in the emergency department (ED), where rapid decisions impact outcomes. While conventional methods like auscultation and capnography are widely used for endotracheal tube (ETT) confirmation, their limitations highlight the need for Airway Ultrasound (AUS), offering real-time imaging and enhanced accuracy in trauma patients. Method: This prospective, single-center study was conducted in the ED of a tertiary care hospital to compare AUS and standard clinical assessment (SCA) for confirming ETT placement during Rapid Sequence Intubation (RSI) in adult trauma patients. Patients were randomized into AUS or SCA groups. Primary outcomes included success rates, number of intubation attempts, and confirmation time and adverse events, including esophageal intubation and hypoxemia. Result: The AUS arm showed higher overall success (100% vs. 96%) and first-attempt success rates (94% vs. 76%) and required fewer attempts (1.06 ± 0.2 vs. 1.22 ± 0.5). Time metrics significantly favored AUS, with faster intubation (8.9 vs. 13.1 seconds) and confirmation (45 vs. 91.4 seconds). Esophageal intubation was significantly less frequent with AUS (6% vs. 18%, p = 0.042). Conclusion: AUS is a transformative tool in trauma airway management, improving visualization, accuracy, efficiency, and safety. With advancing technology, integrating AUS, standardized protocols, and training will solidify its role in trauma care, ensuring safer and more effective outcomes in emergency medicine.