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The Esophageal Detector Device: Accuracy and Reliability in Difficult Airway Settings

Published online by Cambridge University Press:  28 June 2012

Christopher E. Kapsner ,
David C. Seaberg ,
Charles Stengel ,
Kaveh Ilkhanipour  and
James Menegazzi
Christopher E. Kapsner*
Affiliation:
University of Pittsburgh Affiliated Residency in Emergency Medicine, Pittsburgh, Pennsylvania Department of Emergency Medicine, The Mercy Hospital of Pittsburgh, Pittsburgh, Pennsylvania
David C. Seaberg
Affiliation:
Vice Chairman of Research, Department of Emergency Medicine, The Mercy Hospital of Pittsburgh, Pittsburgh, Pennsylvania Division of Emergency Medicine, University Medical Center, Jacksonville, Florida
Charles Stengel
Affiliation:
University of Pittsburgh Affiliated Residency in Emergency Medicine, Pittsburgh, Pennsylvania Department of Emergency Medicine, The Mercy Hospital of Pittsburgh, Pittsburgh, Pennsylvania
Kaveh Ilkhanipour
Affiliation:
Division of Emergency Medicine, University Medical Center, Jacksonville, Florida
James Menegazzi
Affiliation:
Director of Research, Center for Emergency Medicine for Western Pennsylvania, Pittsburgh, Pennsylvania
*
Emergency Medicine Association of Pittsburgh, 13 Pride St., Pittsburgh, PA 15219USA
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Abstract

Introduction:

The esophageal detector device (EDD) recently has been found to assess endotracheal (ET) tube placement accurately. This study describes the reliability of the EDD in determining the position of the ET tube in clinical airway situations that are difficult.

Methods:

This was a prospective, randomized, single-blinded, controlled laboratory investigation. Two airway managers (an emergency-medicine attending physician and a resident) determined ET-tube placement using the EDD in five swine in respiratory arrest. The ET tube was placed in the following clinical airway situations: 1) esophagus; 2) esophagus with 1 liter of air instilled; 3) trachea; 4) trachea with 5 ml/kg water instilled; and 5) right mainstem bronchus. Anatomic location of the tube was verified by thoracotomy of the left side of the chest.

Results:

There was 100% correlation between the resident and attending physician's use of the EDD. The EDD was 100% accurate in determining tube placement in the esophagus, in the esophagus with 1 liter of air instilled, in the trachea, and in the right mainstem bronchus. The airway managers were only 80% accurate in detecting tracheal intubations when fluid was present.

Conclusions:

The EDD is an accurate and reliable device for detecting ET-tube placement in most clinical situations. Tube placement in fluid-filled trachea, lungs, or both, which occurs in pulmonary edema and drowning, may not be detected using this device.

Keywords

complicationsendotracheal intubationesophageal detector deviceesophageal intubationintubationsporcine modelpulmonary edematubesventilation
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 11 , Issue 1 , March 1996 , pp. 60 - 62
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1996

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