What is the gold standard method for confirming the placement of an endotracheal tube?

The gold standard method for confirming the placement of an endotracheal tube is a chest X-ray. This imaging technique provides a clear visual confirmation of the tube's placement within the trachea, ensuring that it is in the correct position and not accidentally placed in the esophagus or mainstem bronchi. A chest X-ray can show the endotracheal tube's tip, typically located 2-4 centimeters above the carina, which is the junction where the trachea branches into the left and right bronchi.

While capnography is a valuable tool that indicates effective ventilation by measuring exhaled carbon dioxide levels, it is considered a reliable indicator rather than a definitive confirmation. Pulse oximetry provides information about oxygen saturation but does not directly address the tube's placement. Clinical assessment, although useful, relies heavily on physical signs and may not be sufficient alone to confirm proper placement. Thus, a chest X-ray serves as the most accurate and definitive method for verifying the correct positioning of an endotracheal tube.