title: End-tidal carbon dioxide detection in emergency intubation in four groups of patients.
abstract: A prospective clinical trial was conducted at a level I trauma center to assess the efficacy of end-tidal carbon dioxide (CO2) detection in four groups of patients requiring emergency intubation because of cardiac arrest, major trauma, respiratory failure, or the need for airway protection. A semiquantitative, colorimetric FEF end-tidal CO2 detector (Fenem, Inc, New York, NY) was used to evaluate endotracheal versus esophageal intubation. This disposable, bedside detector registers three ranges of CO2 concentration: "A" (purple) indicates low levels and probable esophageal intubation; "B" (beige) indicates moderate levels and probable tracheal intubation with hypocarbia; "C" (yellow) indicates high levels and tracheal intubation. Clinical observation, patient response, chest x-ray films, and arterial blood gas results were used to corroborate placement of the endotracheal tube. The FEF detector was found to be 100% reliable for confirming tracheal placement when registering levels in the B and C ranges and 100% reliable for detecting esophageal intubation when registering levels in the A range. In conclusion, the FEF CO2 detector is a reliable and useful adjunct for airway management of diverse groups of patients in the emergency setting.
authors.affiliation: Department of Emergency Medicine, Martin Luther King Jr Medical Center, Los Angeles, California.
authors.forename: K C
authors.initials: KC
authors.lastname: Sanders
authors.forename: W B
authors.initials: WB
authors.lastname: Clum
authors.forename: S S
authors.initials: SS
authors.lastname: Nguyen
authors.forename: S
authors.initials: S
authors.lastname: Balasubramaniam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide / Q000378:metabolism*; D003124:Colorimetry; D004630:Emergencies; D004947:Esophagus; D006323:Heart Arrest; D006801:Humans; D007442:Intubation, Intratracheal; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation; D011446:Prospective Studies; D012123:Pulmonary Ventilation; D012131:Respiratory Insufficiency; D014947:Wounds and Injuries
chemical_list: D002245:Carbon Dioxide