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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. ,
David R. Eitel ,
Mark F. Koch ,
Dean R. Hess  and
Michael A. Taigman
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
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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.

Keywords

airway managementendotracheal intubationesophageal detection deviceintubationintubation/instrumentationprehospital care
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 11 , Issue 3 , September 1996 , pp. 223 - 227
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1996

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