Pressure changes over the anterior neck during tracheal and oesophageal intubation

Pressure changes were measured on the skin over the cricoid and thyroid car tilages during intubation of the oesophagus or trachea in 21 consenting pat ients. A 100-ml bag of saline was firmly fixed to the anterior neck and the pressure changes in the bay recorded. Typical and distinctively different pressure patterns for tracheal and oesophageal intubation were recorded. Oe sophageal intubation was accompanied by a statistic-ally significantly high er and longer pressure rise and, most characteristically by an obvious and sustained rise in baseline pressure. This method is, however, neither pract ical nor recommended for clinical use in detecting accidental oesophageal i ntubation. Capnography should always be used during tracheal intubation as an ongoing capnographic waveform provides the only guarantee of correct tra cheal placement.