AIRWAY AUSCULTATION - A NEW METHOD OF CONFIRMING TRACHEAL INTUBATION

Unrecognised accidental oesophageal intubation remains an important ca use of morbidity and mortality in anaesthetic practice. We have evalua ted a new method of distinguishing tracheal from oesophageal intubatio n using a simple adaptation of an ordinary stethoscope which is insert ed into the patient end of the breathing system. We call this techniqu e 'airway auscultation'. Characteristic sounds are heard with the stet hoscope during inflation and deflation which allow the observer to dia gnose the position of the tube. When the tube is in the trachea loud b reath sounds are heard. In contrast, when the tube is in the oesophagu s either squeaks or a flatus-like noise is heard or else there is no s ound. In 100 healthy adults two observers rapidly identified 99 intuba tions correctly in a randomised single-blind trial. We recommend furth er widespread evaluation of this device as it appears to be an effecti ve, simple and rapid method of detecting oesophageal intubation and co nfirming tracheal intubation which may be of particular use in situati ons where capnography is not available.