Confirmation of endotracheal tube placement: a miniaturized infrared qualitative CO2 detector

R B Vukmir, M B Heller, K L Stein
Annals of Emergency Medicine 1991, 20 (7): 726-9

STUDY OBJECTIVES: A miniaturized, infrared, solid-state, end-tidal CO2 detector was used to confirm emergency endotracheal tube (ETT) placement.

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

SETTING: The ICU, emergency department, and hospital floor.

TYPE OF PARTICIPANTS: There were 88 consecutive adult patients requiring 100 emergency intubations.

MEASUREMENTS AND MAIN 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).

CONCLUSION: This hand-held infrared capnometer reliably confirms ETT placement under emergency conditions.

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