IDEAL Position of Endotracheal Tubes, UACs and UVCs on X-rays!!

For the PDF summary of THIS video, (+ 50 free Multiple Choice Questions/ Answers and explanations!!), AND a bunch of other stuff, subscribe to our Neonatal Nuggets Newsletter here:
talatalksnicu....
Review where endotracheal tubes, umbilical venous catheters and umbilical arterial catheters should end up on neonatal X-rays. 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 board-certified 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.
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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 Meta-Analysis. 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. Real-time 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/s13052-021-01014-7. 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 X-ray 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 7-8-9 Rule for endotracheal tube placement in the neonate. J Perinatol 26, 333-336 (2006). doi.org/10.103...
Paudel, Krishna Prasad et al. “Accuracy of 7-8-9 Rule for Endotracheal Tube Placement in Nepalese Neonates.” Journal of Nepal Paediatric Society 31 (2011): 175-179.
NRP 8th edition
Liu, Hsien-Kuan, Yung-Ning Yang, Shu-Leei Tey, Pei-Ling Wu, San-Nan Yang, and Chien-Yi Wu. 2021. "Weight Is More Accurate than Gestational Age When Estimating the Optimal Endotracheal Tube Depth in Neonates" Children 8, no. 5: 324. doi.org/10.339...
West J Emerg Med. 2015 Jul; 16(4): 575-576.
Published online 2015 Jun 17. doi: 10.5811/westjem.2015.4.25821
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Ahmed, Aadil. (2015). Where's the line/tube?. South African Journal of Radiology. 19. 10.4102/sajr.v19i2.888.
radiologyassis...
Al-Dajani 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.
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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
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*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.

[@bangaloresatish6600]

Excellent lecture, can’t thank you enough. A great collection of X-rays and explanations. The quiz at the end was superb. A masterpiece on lines and tubes.👍🏽

[@TalaTalksNICU]

Thank you so much!!!!!! What a lovely comment!

[@thakorbhaivankar9838]

Excellent talk madam. Life saving tips.🎉🎉

[@TalaTalksNICU]

So glad you think so! Thanks so much for taking the time to comment!

[@didan9203]

what a great video and excellent way of teaching !!

[@TalaTalksNICU]

Thank you for the lovely compliment!

[@agotabende8719]

Thank you for another excellent video.!🤗 We all are learning a lot from them. ☺️ I would like to ask you to make a video about pain management of newborns ? How do you practise pain management before the procedures/in palliative care, in your unit?

[@TalaTalksNICU]

Hello! Thank you so much for your encouraging comment! Happy anyone learning anything!!! A video on pain meds is a fantastic idea!!!! Will force me to read recent literature too so I like that!!! Thank you for the great suggestion!

[@dralamtraveltales2557]

one of ur best and most informative and helpful video. great job TALA

[@TalaTalksNICU]

Oh perfect!!! So glad you think so! Always so hard choosing what to include and exclude in videos- always so happy to hear that they’re helpful in any way! Thank you!

Hello... I appreciate all your videos and how great they are. I would like to ask you to make a video dedicated to neonatal life support/resuscitation in and out delivery room and pneumothorax/chest drains for one of your next topics.

[@TalaTalksNICU]

Hello!! Thanks so much!! Yes- those are two videos we're planning on filming by the end of the year- I have the chest tubes sitting waiting to be used!!! Thank you so much for being here :)

[@smilerkris]

Always great to refresh, thank you for the lecture! 😊

[@TalaTalksNICU]

Thank you for watching and for taking the time to comment!

[@naitramsingh6942]

Really excellent video and great bank of xray, as always your videos are amazing

[@TalaTalksNICU]

Hi Dr. Singh!!! Thank you so much! So grateful for everyone publishing their X-rays!!! Again thank you so much for your support!

[@drheshamelkordi8529]

Thanks so much ,may u talk about fungal infection in preterm

[@TalaTalksNICU]

OH yes! This is a great subject! Thanks for the suggestion!!!

[@mohammedmaheer4740]

Excellent dear dr.

[@TalaTalksNICU]

Thank you so much!!!! You are always so encouraging! Thank you!

[@laraeb2514]

Another great video!

[@TalaTalksNICU]

Hi Lara! This was so great because I didn’t have to film myself! Ha! Could do these X-ray ones forever but would get increasingly rarer- X-rays of osteopenia then X-rays of OI and stuff!!!!

[@laraeb2514]

@@TalaTalksNICU those could be interesting to see!!

[@quinchoco-sb6ul]

Excellent 🎉

[@TalaTalksNICU]

Thank you so much!!!

[@ابراهيمهواري-س3غ]

Wonderful as usual

[@TalaTalksNICU]

This was such a lovely comment- thank you for being here and being so supportive as always!

[@abelitasousa6053]

What is the best way of calculation UAC and UVC? Update formula please

[@TalaTalksNICU]

The one we use is for UAC: ((Weight (kg) x 3)) + 9 Then for Uvc divide by 2 and plus 1 cm

[@irreplacableable]

How do you count veterbrae ??

[@TalaTalksNICU]

Usually from bottom- assuming T12 has last rib. But sometimes babies don’t have 12 ribs- so count from top. t1 has first rib. The first rib is usually smaller so may take a few seconds to figure out anatomy. And URGH! I should have added that to talk! Thank you!

[@irreplacableable]

@@TalaTalksNICU thanks a lot mam

[@加先邓]

It seems that Lala's voice has changed, do you have a cold? Please take good care of yourself.

[@TalaTalksNICU]

You’re so sweet!!! It was recorded through my computer so came off funnily! I’ve been looking into microphones- the one I have was even worse!!! Sorry though! We’ll work on audio!!!!

[@irreplacableable]

That heaven ,great,fine works for uac...not uvc

[@TalaTalksNICU]

You’re right- it’s not prefect either way!!!! T6-9 is ok for uac so don’t have to fix at 6. For the uvc it’s good to have direction but it really comes down to what’s happening with the infant’s lungs/ chest. Hyper or hypo expanded can really determine where line ends up. Thank you for your comment!