A disposable end-tidal CO2 detector to verify endotracheal intubation.
OBJECTIVE
We compared the performance of the Fenem FEF end-tidal CO2 detector with the TRIMED capnometer to verify endotracheal intubation.


METHODS
The FEF indicates the presence of CO2 by the color change of a chemically treated indicator; the TRIMED uses infrared technology. Both devices were used during 60 intubations.


METHODS
Intubations during in-hospital emergency situations outside of the operating room were studied.


METHODS
Adult patients undergoing intubation for respiratory failure, CPR, and other airway protection situations were enrolled in the study.


METHODS
The TRIMED monitor and FEF detector were placed in series between the manual resuscitator and the patient's endotracheal tube adapter after endotracheal tube placement.


RESULTS
We defined the acceptable criterion for detection of CO2 as production of a positive signal within six manual resuscitator bag breaths. The TRIMED met this criterion in 58 of 60 patients (sensitivity, 0.97) and the FEF met this criterion in 59 of 60 patients (sensitivity, 0.98). A paired t test showed no statistically significant difference in performance between the two devices. In five of nine cases of intubation during CPR, the color change of the FEF was described as "subtle." In one CPR case, a positive signal was not obtained by either device.


CONCLUSIONS
We conclude that the performance of the FEF CO2 detector is equal to that of the TRIMED monitor for verification of endotracheal intubation in nonCPR situations. Interpretation of FEF color changes during CPR should be approached with caution until further studies using the FEF during CPR are completed.
Anton
W R
WR
Respiratory Care Services, University of Washington Medical Center, Seattle 98195.
Gordon
R W
RW
Jordan
T M
TM
Posner
K L
KL
Cheney
F W
FW
D000328:Adult; D002245:Carbon Dioxide / Q000032:analysis*; D003124:Colorimetry / Q000592:standards*; D004209:Disposable Equipment / Q000592:standards; D004636:Emergency Service, Hospital; D005069:Evaluation Studies as Topic; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D015203:Reproducibility of Results; D013055:Spectrophotometry, Infrared / Q000592:standards*; D013990:Tidal Volume
D002245:Carbon Dioxide