• M S Bhende, A E Thompson, D R Cook, and A L Saville.
• Emergency Department, Children's Hospital of Pittsburgh, Pennsylvania.
• Ann Emerg Med. 1992 Feb 1;21(2):142-5.

Study ObjectiveTo examine the validity of a disposable, colorimetric end-tidal CO2 detector in verifying endotracheal tube (ETT) placement in infants and children.DesignThe detector was studied prospectively in 151 intubations.SettingOperating room, ICU, and emergency department of a children's hospital.ParticipantsOne hundred thirty-seven children undergoing endotracheal intubation for anesthesia (52), respiratory support (76), or CPR (23).InterventionsAfter endotracheal intubation, tube position was verified, the detector was attached, and readings were obtained.Measurements And ResultsThe detector correctly identified tube position (trachea, 124; esophagus, four) in all 120 patients who were not in cardiac arrest (P less than .01). In the cardiac arrest setting, all six esophageal intubations were correctly identified, but two of the 17 tracheal intubations were incorrectly interpreted as esophageal intubations (P less than .01).ConclusionThe detector accurately identifies ETT position in children with spontaneous circulation who weigh more than 2 kg. During CPR, a positive test correctly indicates that the ETT is in the airway, but a negative result (suggesting esophageal placement) requires an alternate means of confirming ETT position.

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