Confirmation of endotracheal tube placement: a miniaturized infrared qualitative CO2 detector.
OBJECTIVE
A miniaturized, infrared, solid-state, end-tidal CO2 detector was used to confirm emergency endotracheal tube (ETT) placement.


METHODS
This prospective, clinical study used a miniature, infrared, solid-state end-tidal CO2 detector to confirm ETT placement in an acute setting.


METHODS
The ICU, emergency department, and hospital floor.


METHODS
There were 88 consecutive adult patients requiring 100 emergency intubations.


RESULTS
The indication for airway intervention was considered urgent in 79% and under arrest conditions in 21%. The mean number of intubation attempts was 1.83 (range, one to five) with difficulty of intubation of 6.48 and confirmation of 7.75, on a linear scale from 0 (lowest) to 10 (highest). Determination of ETT position revealed intratracheal intubation in 96% and esophageal intubation in 4%. Placement was confirmed by direct visualization or radiography in all cases. Sensitivity and specificity for ETT localization was 100% (P less than .0001).


CONCLUSIONS
This hand-held infrared capnometer reliably confirms ETT placement under emergency conditions.
Vukmir
R B
RB
Department of Critical Care Medicine/Anesthesia, Presbyterian-University Hospital, Pittsburgh, Pennsylvania.
Heller
M B
MB
Stein
K L
KL
D002245:Carbon Dioxide / Q000032:analysis*; D004630:Emergencies; D005069:Evaluation Studies as Topic; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D011446:Prospective Studies
D002245:Carbon Dioxide