Tracheal ultrasound can be an alternative diagnostic tool in airway management, besides traditional confirmatory methods such as capnography and auscultation. The standard image is a hyperechoic air–mucosa (A–M) interface with a reverberation artifact posteriorly (comet-tail artifact). If the second A–M interface appears, which we call a “double-tract sign,” esophageal intubation is considered.
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