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Ultrasound evaluation of the airway in the ED: a feasibility study

Overview of attention for article published in Critical Ultrasound Journal, January 2018
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#43 of 179)
  • High Attention Score compared to outputs of the same age (88th percentile)

Mentioned by

24 tweeters
3 Facebook pages
1 Google+ user


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57 Mendeley
Ultrasound evaluation of the airway in the ED: a feasibility study
Published in
Critical Ultrasound Journal, January 2018
DOI 10.1186/s13089-018-0083-6
Pubmed ID

Elizabeth A. Hall, Ibrahim Showaihi, Frances S. Shofer, Nova L. Panebianco, Anthony J. Dean


Recognition of the difficult airway is a critical element of emergency practice. Mallampati score and body mass index (BMI) are not always predictive and they may be unavailable in critically ill patients. Ultrasonography provides high-resolution images that are rapidly obtainable, mobile, and non-invasive. Studies have shown correlation of ultrasound measurements with difficult laryngoscopy; however, none have been performed in the Emergency Department (ED) using a consistent scanning protocol. This study seeks to determine the feasibility of ultrasound measurements of the upper airway performed in the ED by emergency physicians, the inter-rater reliability of such measurements, and their relationship with Mallampati score and BMI. A convenience sample of volunteer ED patients and healthy volunteers with no known airway issues, aged > 18 years, had images taken of their airway using a standardized ultrasound scanning protocol by two EM ultrasound fellowship trained physicians. Measurements consisted of tongue base, tongue base-to-skin, epiglottic width and thickness, and pre-epiglottic space. Mean and standard deviation (SD) were used to summarize measurements. Inter-rater reliability was assessed by intraclass correlation coefficients (ICCs). Analysis of variance with linear contrasts was used to compare measurements with Mallampati scores and linear regression with BMI. Of 39 participants, 50% were female, 50% white, 42% black, with median age 32.5 years (range 19-90), and BMI 26.0 (range 19-47). Mean ± SD for each measurement (mm) was as follows: tongue base (44.6 ± 5.1), tongue base-to-skin (60.9 ± 5.3), epiglottic width (15.0 ± 2.8) and thickness (2.0 ± 0.37), and pre-epiglottic space (11.4 ± 2.4). ICCs ranged from 0.76 to 0.88 for all measurements except epiglottis thickness (ICC = 0.57). Tongue base and tongue base-to-skin thickness were found to increase with increasing Mallampati score (p = .04, .01), whereas only tongue-to-skin thickness was loosely correlated with BMI (r = .38). A standardized ultrasound scanning protocol demonstrates that the airway can be measured by emergency sonologists with good inter-operator reliability in all but epiglottic thickness. The measurements correlate with Mallampati score but not with BMI. Future investigation might focus on ultrasound evaluation of the airway in patients receiving airway management to determine whether ultrasound can predict challenging or abnormal airway anatomy prior to laryngoscopy.

Twitter Demographics

The data shown below were collected from the profiles of 24 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 57 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 57 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 13 23%
Other 13 23%
Researcher 7 12%
Student > Bachelor 6 11%
Librarian 3 5%
Other 7 12%
Unknown 8 14%
Readers by discipline Count As %
Medicine and Dentistry 40 70%
Agricultural and Biological Sciences 3 5%
Nursing and Health Professions 2 4%
Computer Science 1 2%
Social Sciences 1 2%
Other 1 2%
Unknown 9 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 16. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 March 2018.
All research outputs
of 17,904,439 outputs
Outputs from Critical Ultrasound Journal
of 179 outputs
Outputs of similar age
of 377,028 outputs
Outputs of similar age from Critical Ultrasound Journal
of 1 outputs
Altmetric has tracked 17,904,439 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 179 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.4. This one has done well, scoring higher than 76% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 377,028 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 88% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them