DETECTION OF ACCIDENTAL ESOPHAGEAL INTUBATION - ROLE OF THE ANESTHETIC ASSISTANT

Three situations in which an anaesthetic assistant might be able to de tect accidental oesophageal intubation during or immediately after int ubation were assessed. These were: firstly whilst applying cricoid pre ssure, secondly whilst applying gentle palpation over the trachea just above the suprasternal notch and, thirdly, after intubation by means of a 'roll test'. During cricoid pressure, tracheal intubation was cor rectly diagnosed;in all of 10 cases. However, deliberate oesophageal i ntubation was only detected in six out of 10 cases. During suprasterna l palpation, three cases out of 10 oesophageal and three cases out of 10 tracheal intubation were misdiagnosed. In the 'roll test', two out of 10 tracheal and five out of 10 oesophageal intubations were misdiag nosed. In conclusion, no method could be relied on entirely and may in deed give false reassurance. Nonetheless, any doubt expressed about th e tracheal tube position by the assistant should be taken seriously an d a careful check made.