Examples of cases in airway POCUS following an I-AIM Framework
| Clinical scenario | Indications | Image acquisition | Image interpretation | Medical decision-making |
| Awake cricothyroidotomy | Location of the cricothyroid membrane Location of the cricoid cartilage Location of tracheal rings | Patient supine with the neck extended Linear high-frequency transducer Scan in transverse and sagittal planes Identify: Thyroid cartilage Cricothyroid membrane Cricoid cartilage Tracheal rings Thyroid gland Surrounding vasculature | Localization of cephalocaudal level, mid-point and size of the cricothyroid membrane Localization of the cephalocaudal level and mid-point of the cricoid cartilage Localization of the cephalocaudal level, mid-point and number of tracheal rings | Determine and mark the skin for the correct location of cricothyroid membrane puncture Determine and mark the skin for the correct location of cricoid force (pressure) |
| Confirmation of correct endotracheal tube placement | Unclear endotracheal intubation Real-time confirmation of endotracheal intubation Rule out esophageal intubation | Patient supine Linear high-frequency transducer Scan in transverse and sagittal planes Identify: Tracheal rings Esophagus Thyroid gland Surrounding vasculature Bilateral lung sliding | Verification of endotracheal tube position (double-bullet sign) Diagnosis of endobronchial intubation (double-bullet sign and unilateral lung sliding (left) Verification of esophageal position (double-tract sign) | Determine the safety of utilization of a tracheal tube for ventilation Reintubation if in the esophagus |
| Confirmation of orogastric or nasogastric tube placement | Orogastric or nasogastric tube placement without aspiration of gastric content by suction | Patient supine Linear high-frequency transducer, potentially curvilinear probe for verification of orogastric or nasogastric tube in the stomach Scan in transverse and sagittal planes Identify: Tracheal rings Esophagus Thyroid gland Surrounding vasculature | Verification of small, round structure in esophagus or stomach | Determine the safety of use of orogastric or nasogastric tube Replacement/adjustment of the position of orogastric or nasogastric tube |
I-AIM, Indication, Acquisition, Interpretation, and Medical decision-making; POCUS, Point-of-care ultrasound.