Bednarek F J, Kuhns L R
Pediatrics. 1975 Aug;56(2):224-9.
In order to decrease complications of improper endotracheal tube positioning, a method of placing the tube by palpation within the suprasternal notch was devised. The method proved to be simple and effective. The accuracy was verified by fluoroscopy and a clinical study comparing this technique with others is reported. No complications of the technique were noted. Once palpation was reliable, the proper position of the tube tip was defined. From measurements taken from routine inspiratory chest radiographs on 142 infants, it was found that a point midway between the medial ends of the clavicle (IMP) was a good position because it approximates the true tracheal midpoint and, therefore, is a good landmark on a chest radiograph. This point allows for movement of the tube tip with head positioning and of the carina with respiration. The tube tip can be placed near the IMP by the suprasternal palpation technique. This method, therefore, is useful in emergency situations or on initial intubations to avoid improper position of the tube tip prior to radiograph verification.
为了减少气管内导管放置不当的并发症，设计了一种通过在胸骨上切迹内触诊来放置导管的方法。该方法被证明简单有效。通过荧光透视验证了其准确性，并报告了一项将该技术与其他技术进行比较的临床研究。未发现该技术有并发症。一旦触诊可靠，就确定了导管尖端的正确位置。通过对142例婴儿常规吸气时胸部X光片的测量发现，锁骨内侧端中点（IMP）是一个很好的位置，因为它接近气管真正的中点，因此是胸部X光片上的一个良好标志。这一点允许导管尖端随头部位置移动以及隆突随呼吸移动。通过胸骨上触诊技术可将导管尖端放置在IMP附近。因此，该方法在紧急情况下或初次插管时很有用，可避免在X光片验证之前导管尖端位置不当。
