Use of transatlantic telebroncoscopy to confirm proper endotracheal tube placement during a simulated chemical, biological, radiological or nuclear or explosive (CBRNE) event

Airway management is a cornerstone of medical support in the event of a chemical, biological, radiological, nuclear, or explosive event (CBRNE). Challenges are presented due to: the potential of having a large number of patients needing immediate treatment, lack of medical providers skilled in complex airway management tasks such as intubation, tactile and movement challenges caused by providers wearing protective gear and copious airway secretions in the event of a nerve agent exposure. These difficulties may increase the chance of emergency providers placing the endotracheal tube in an improper location during intubation. This study utilized telebronchoscopy to confirm proper endotracheal tube placement by anesthesia providers located at a transcontinental site. The results of this paper show that tele-video laryngoscopy and telebronchoscopy may be useful tools for emergency personnel providing airway management in the event of a CBRNE situation.