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The esophageal detector device: accuracy and reliability in difficult airway settings
C E Kapsner1, D C Seaberg, C Stengel
1University of Pittsburgh Affiliated Residency in Emergency Medicine, Pittsburgh, Pennsylvania, 15219, USA.
Prehospital and Disaster Medicine
|December 9, 1995
Summary
The esophageal detector device (EDD) accurately confirms endotracheal (ET) tube placement in most airway scenarios. However, its reliability decreases in cases of fluid-filled airways, impacting its use in conditions like drowning.
Area of Science:
- Medical Devices
- Emergency Medicine
- Airway Management
Background:
- The esophageal detector device (EDD) has emerged as a tool for assessing endotracheal (ET) tube placement.
- This study evaluates the EDD's reliability in challenging clinical airway situations.
Purpose of the Study:
- To determine the accuracy and reliability of the esophageal detector device (EDD) for endotracheal (ET) tube placement.
- To assess EDD performance in various simulated difficult airway scenarios.
Main Methods:
- Prospective, randomized, single-blinded, controlled laboratory investigation.
- Two experienced airway managers used the EDD to determine ET tube placement in swine under respiratory arrest.
- Simulated scenarios included esophageal, tracheal, and right mainstem bronchus placement, with and without instilled fluids.
Main Results:
- 100% correlation observed between resident and attending physician use of the EDD.
- The EDD demonstrated 100% accuracy in detecting tube placement in the esophagus, trachea, and right mainstem bronchus.
- Accuracy decreased to 80% when detecting tracheal intubations in the presence of fluid.
Conclusions:
- The esophageal detector device (EDD) is accurate and reliable for ET tube placement in most clinical settings.
- EDD performance may be compromised in fluid-filled airway situations, such as those seen in pulmonary edema or drowning.