Which method is considered the gold standard for confirming endotracheal tube placement?

Waveform capnography is recognized as the gold standard for confirming endotracheal tube placement due to its high level of accuracy in detecting exhaled carbon dioxide (CO2). This method provides real-time feedback on the presence of CO2 in the exhaled breath, which indicates that the tube is correctly placed in the trachea, where it can connect to the lungs and allow for gas exchange.

Unlike other methods, waveform capnography displays a continuous and measurable waveform that reflects the patient's respiratory status. A consistent and appropriate wave pattern signifies proper placement; if the tube is misplaced in the esophagus, the CO2 levels will be insufficient to generate a waveform or display a shallow one.

While the evaluation of breath sounds and observing equal chest rise and fall are useful methods for assessing tube placement, they can be subjective and may not provide definitive confirmation. Similarly, the presence of condensation in the tube can occur even if the tube is improperly placed, making it an unreliable indicator on its own. Therefore, waveform capnography stands out as the most reliable and standardized approach to confirm the placement of an endotracheal tube.