Confirmation of endotracheal tube placement: A miniaturized infrared qualitative Co2 detector

Abstract

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 < .0001). Conclusion: This hand-held infrared capnometer reliably confirms ETT placement under emergency conditions. © 1991 American College of Emergency Physicians.