Verification of endotracheal tube placement by prehospital providers: is a portable fiberoptic bronchoscope of value?

Air Medical Journal
Timothy AngelottiJohn Brock-Utne

Abstract

This study was designed to examine whether a handheld, battery-operated fiberoptic bronchoscope (FOB) used to verify endotracheal tube (ETT) placement would be as sensitive and specific as other modes and whether a combination of multiple modes would further enhance the sensitivity and specificity of ETT placement verification. An academic hospital-based air medical program. This was a prospective, randomized study examining surgical patients undergoing general endotracheal anesthesia. Eighteen critical care transport (CCT) nurses, previously unfamiliar with FOB, were asked to identify intratracheal and intraesophageal ETTs by using misting, end-tidal carbon dioxide concentration (ETCO(2)), and FOB alone or with a combination of all three modes. The sensitivity and specificity of single and multimode verification were calculated and compared. Comparison of ETT verification by single mode alone revealed a rank order of sensitivity with ETCO(2) (0.97) > FOB (0.87) > misting (0.84), whereas all three modes had similar specificities (0.93-0.94). However, the use of the three-mode combination revealed a sensitivity and specificity of 1.0. As a single mode for ETT verification, use of a handheld, battery-operated FOB device allowed f...Continue Reading

References

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Citations

Oct 16, 2007·Resuscitation·G GemesG Prause
Oct 1, 2010·Journal of Bronchology & Interventional Pulmonology·Rex C Yung
Jan 20, 2009·Anesthesia and Analgesia·Bruno MarciniakBruno Bissonnette
Sep 28, 2007·Anesthesia and Analgesia·Timothy Angelotti, John Brock-Utne
Mar 29, 2013·Journal of Clinical Monitoring and Computing·John George KarippacherilShetty Nanda
Dec 12, 2019·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Sunao YamauchiMark A Merlin
Apr 30, 2011·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Bunyamin MusluKadriye Serife Boynukalin

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