What is considered the gold standard for confirming advanced airway placement?

The gold standard for confirming advanced airway placement is ETCO2, or End-Tidal Carbon Dioxide monitoring. This method measures the concentration of carbon dioxide (CO2) in the exhaled breath, which is an effective indicator that an endotracheal tube is properly placed in the trachea, as CO2 is produced by the body's metabolism and expelled through the lungs.

When the airway is correctly secured in the trachea, the presence of ETCO2 in the exhaled breath confirms ventilation and indicates that the patient is likely being adequately ventilated. A sufficient level of ETCO2 indicates proper placement and functioning of the airway device, whereas lack of ETCO2 would suggest misplacement, such as in the esophagus.

Other methods, while useful for assessing airway placement, do not provide the same level of certainty as ETCO2 monitoring. For example, capnography offers real-time evaluation of ETCO2 but is often seen as a combination of techniques, including the waveform interpretation than just numerical values. Pulse oximetry measures oxygen saturation in the blood, which can be affected by various factors and does not directly confirm airway placement. Chest X-ray, although a definitive method for confirming placement, is not practical in emerg