Clinical test to confirm tracheal intubation: a new method to confirm endotracheal intubation in the absence of capnography.
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.
Baigel
G
G
Kettering General Hospital, Kettering, UK. garyleah@optusner.com.au
Safranski
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001314:Auscultation; D001980:Bronchi; D019296:Capnography; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results