The esophageal detector bulb in the aeromedical setting
Presented at the meeting of the Society of Academic Emergency Medicine (SAEM), Atlanta, GA, May 2001, and at the CAL/ACEP Scientific Assembly, Santa Clara, CA, June 2001.
Received 7 August 2001; received in revised form 24 January 2002; accepted 19 February 2002.
Abstract
To determine the accuracy of the Esophageal Detector Bulb (EDB) in the aeromedical setting, we conducted a prospective, observational study of all intubated patients transported by an aeromedical program over two years. Flight personnel recorded the results of the EDB, clinical examination, pulse oximetry, and capnography (ETCO2). Endotracheal tube position was confirmed by prehospital ETCO2 or by the receiving emergency physician. There were 104 EDB assessments in 53 patients. The EDB correctly identified four of five esophageal intubations and 96 of 99 tracheal intubations. The sensitivity and specificity of the EDB in the detection of an esophageal intubation were 80% (95% CI, 38–96%) and 97% (95% CI, 92–99%), respectively, and the overall accuracy was 96% (95% CI, 90–98%). The EDB augments the ability of an aeromedical crew to determine endotracheal tube position, but its results must be carefully interpreted in the context of other available means of confirmation of endotracheal tube position.
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