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Prehospital Use of a Prototype Esophageal Detection Device: A Word of Caution!

Published online by Cambridge University Press:  28 June 2012

Charles D. Marley Jr.*
Affiliation:
Advanced Life Support Director, Hanover General Hospital, Hanover, Pennsylvania
David R. Eitel
Affiliation:
Residency Research Director, Emergency Medicine Residency, York Hospital, York, Pennsylvania
Mark F. Koch
Affiliation:
York Hospital Advanced Life Support Unit, York Hospital, York, Pennsylvania
Dean R. Hess
Affiliation:
Respiratory Care, Massachusetts General Hospital, Boston, Massachusetts
Michael A. Taigman
Affiliation:
MedTrans, Oakland, California
*
Hanover General Hospital, 300 Highland Avenue, Hanover, PA 17331, USA

Abstract

Objective:

To determine the effectiveness of a prototype esophageal detection device (EDD) during use in the prehospital setting.

Design/Setting:

Prospective convenience sample in a prehospital setting.

Population:

Intubated adult patients.

Interventions:

The study device was used to determine esophageal or endotracheal placement of endotracheal tubes in intubated patients. Clinical means were used to confirm tube location. A data sheet was completed for each patient.

Results:

Of 105 uses of the device, 17 of 17 esophageal tubes were identified correctly (100% sensitivity). Sixty-five of 88 tracheal tubes were correctly identified (78% specificity). There was intermediate reinflation of the device on 13 of the 65 tracheal tubes. Five tests were indeterminate. There were no false negatives (negative predictive value 100%), but 18 false positives (positive predictive value 48%).

Conclusion:

This prototype EDD adequately identifies esophageally placed endotracheal tubes. Correct identification of endotracheally placed tubes was less sensitive. Much work needs to be done regarding the use of negative aspiration devices to identify placement of endotracheal tubes.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1996

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References

1. Marley, CD, Eitel, DR, Anderson, TE, et al. : Evaluation of a prototype esophageal detection device. Acad Emerg Med 1995;2:503507.CrossRefGoogle ScholarPubMed
2. Andersen, KH, Hald, A: Assessing the position of the tracheal tube: The reliability of different methods. Anesthesia 1989;44:984985.CrossRefGoogle Scholar
3. Wee, MYK: The oesophageal detector device: Assessment of a new method to distinguish oesophageal from tracheal intubation. Anaesthesia 1988;43:2729.CrossRefGoogle Scholar
4. Zaleski, L, Abello, D, Gold, MI: The esophageal detector device: Does it work? Anesthesiology 1993;79:242247.CrossRefGoogle ScholarPubMed
5. Vukmir, RB, Heller, MB, Stein, KL: Confirmation of endotracheal tube placement: A miniaturized infrared qualitative CO2 detector. Ann Emerg Med 1991;20:726729.CrossRefGoogle ScholarPubMed
6. Wee, MYK, Walker, AKY: The oesophageal detector device: An assessment with uncuffed tubes in children. Anaesthesia 1991;46:869871.CrossRefGoogle ScholarPubMed
7. Haynes, SR, Morton, NS: Use of the oesophageal detector device in children under one year of age. Anaesthesia 1990;45:10671069.CrossRefGoogle ScholarPubMed
8. Oberly, D, Stein, S, Hess, D, et al. : An evaluation of the esophageal detection device. Am J Emerg Med 1992;10:317320.CrossRefGoogle Scholar
9. O'Leary, JJ, Pollard, BJ, Ryan, JJ: A method of detecting oesophageal intubation or confirming tracheal intubation. Anaesthesia and Intensive Care 1988;16:299301.Google ScholarPubMed
10. Salem, MR, Safai, Y, Joseph, NJ, et al. : Efficacy of the self-inflating bulb in detecting esophageal intubation. Anesthesiology 1994;80:4248.CrossRefGoogle ScholarPubMed
11. Simple esophageal detector may increase intubation safety. Biomedical Safety and Standards 1994;24:9091.Google Scholar
12. Morton, NS, Stuart, JC, Thomson, MF, Wee, MYK: The oesophageal detector device: Successful use in children. Anaesthesia 1989;44:523524.CrossRefGoogle ScholarPubMed
13. Williams, KN, Nunn, JF: The oesophageal detector device: A prospective trial on 100 patients. Anaesthesia 1989;44:412414.CrossRefGoogle Scholar
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