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Review where endotracheal tubes, umbilical venous catheters and umbilical arterial catheters should end up on neonatal Xrays. Where are they when they're too deep or just in the WRONG place!? Learn the basic essential anatomy you need to know!


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Dr. Tala is a boardcertified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.

References:
Congedi S, Savio F, Auciello M, Salvadori S, Nardo D, Bonadies L. Sonographic Evaluation of the Endotracheal Tube Position in the Neonatal Population: A Comprehensive Review and MetaAnalysis. Front Pediatr. 2022 Jun 2;10:886450. doi: 10.3389/fped.2022.886450. PMID: 35722478; PMCID: PMC9201277.
Rubortone SA, Costa S, Perri A, D'Andrea V, Vento G, Barone G. Realtime ultrasound for tip location of umbilical venous catheter in neonates: a pre/post intervention study. Ital J Pediatr. 2021 Mar 18;47(1):68. doi: 10.1186/s13052021010147. PMID: 33736669; PMCID: PMC7977571.
Tang CHM, Seah JCY, Ahmad HK, Milne MR, Wardman JB, Buchlak QD, Esmaili N, Lambert JF, Jones CM. Analysis of Line and Tube Detection Performance of a Chest Xray Deep Learning Model to Evaluate Hidden Stratification. Diagnostics (Basel). 2023 Jul 9;13(14):2317. doi: 10.3390/diagnostics13142317. PMID: 37510062; PMCID: PMC10378683.
Peterson, J., Johnson, N., Deakins, K. et al. Accuracy of the 789 Rule for endotracheal tube placement in the neonate. J Perinatol 26, 333–336 (2006). https://doi.org/10.1038/sj.jp.7211503
Paudel, Krishna Prasad et al. “Accuracy of 789 Rule for Endotracheal Tube Placement in Nepalese Neonates.” Journal of Nepal Paediatric Society 31 (2011): 175179.
NRP 8th edition
Liu, HsienKuan, YungNing Yang, ShuLeei Tey, PeiLing Wu, SanNan Yang, and ChienYi Wu. 2021. "Weight Is More Accurate than Gestational Age When Estimating the Optimal Endotracheal Tube Depth in Neonates" Children 8, no. 5: 324. https://doi.org/10.3390/children8050324
West J Emerg Med. 2015 Jul; 16(4): 575–576. 
Published online 2015 Jun 17. doi: 10.5811/westjem.2015.4.25821
https://pediatricimaging.org/diseases...
https://starship.org.nz/healthprofes...
Ahmed, Aadil. (2015). Where's the line/tube?. South African Journal of Radiology. 19. 10.4102/sajr.v19i2.888.
https://radiologyassistant.nl/pediatr...
AlDajani N, Osiovich H, Smyth J, Byrne A, Jamieson D, Kaczala G. Umbilical Venous Catheter Position: The Value of Acquiring a Lateral in Addition to a Frontal Chest Radiograph. Cureus. 2023 Oct 7;15(10):e46642. doi: 10.7759/cureus.46642. PMID: 37808595; PMCID: PMC10560078.
https://ashfordstpeters.net/Guideline...
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**TIMESTAMPS**
00:35 The future of using AI
1:00 Ideal position of ETT In neonates
02:51 ETT calculation depth
03:40 Continued ETT position
09:36 Ideal position of UVC
16:24 Ideal position of UAC
19:15 Quiz questions

*Disclaimer*: This video is intended for educational purposes only and while we strive to give the most accurate information, errors may occur. Subsequently, this video should not be a replacement for medical advice.