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Clinical test to confirm tracheal intubation: a new method to confirm endotracheal intubation in the absence of capnography

Published online by Cambridge University Press:  11 July 2005

G. Baigel  and
J. Safranski
G. Baigel
Affiliation:
Kettering General Hospital, Kettering, UK
J. Safranski
Affiliation:
Kettering General Hospital, Kettering, UK
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Extract

Summary

Background and objective: Advancing an uncut endotracheal tube into the right main bronchus produces unilateral breath sounds. We wanted to test the validity of using this method to distinguish oesophageal from tracheal intubation.

Methods: Forty-two patients were randomized into two groups. The first group was randomized to receive an endotracheal tube that was advanced into the right main bronchus. The second group of patients had their tracheas intubated as normal and then a second endotracheal tube was placed in the oesophagus. Blinded observers were then asked to decide by auscultation if the patients had unilateral breath sounds or not and if they were bronchial and therefore to decide if endotracheal intubation had occurred.

Results: Ninety-one per cent of patients (95% CI 0.71–0.99) intubated in the right main bronchus were correctly identified by unilateral breath sounds confirming the usefulness of this test.

Conclusions: Advancing an endotracheal tube into the right main bronchus and auscultation of unilateral breath sounds is a useful way of confirming tracheal intubation.

Keywords

INTRATRACHEAL, INTUBATION
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 6 , June 2003 , pp. 475 - 477
Copyright
© 2003 European Society of Anaesthesiology

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References

Edwards G, Morton HJV, Pask EA, Wylie WD. Deaths associated with anaesthesia. A report on 1000 cases. Anaesthesia 1956; 11: 194–199.Google Scholar
Peterson AW, Jacker LM. Death following inadvertent oesophageal intubation: a case report. Anesth Analg 1973; 52: 398–401.Google Scholar
Wee MYK. The oesophageal detector device. Assessment of a new method to distinguish oesophageal from tracheal intubation. Anaesthesia 1988; 43: 27–29.Google Scholar
Andersen KH, Hald A. Assessing the position of the tracheal tube. The reliability of different methods. Anaesthesia 1989; 44: 984–985.Google Scholar
Birmingham PK, Cheney FW, Ward RJ. Esophageal intubation: a review of detection techniques. Anesth Analg 1986; 65: 886–891.Google Scholar
MacLeod BA, Heller MB, Gerard J, Yealy DM, Menegazzi JJ. Verification of endotracheal tube placement with colorimetric end-tidal CO2 detection. Ann Emerg Med 1991; 20: 267–270.Google Scholar
Andersen KH, Schultz-Lebahn T. Oesophageal intubation can be undetected by auscultation of the chest. Acta Anaesth Scand 1994; 38: 580–582.Google Scholar
Scott DB. Endotracheal intubation: friend or foe. BMJ 1986; 292: 157–158.Google Scholar