Abstract
Endotracheal intubation is a common life-saving procedure implemented in emergency care to ensure patient oxygenation, but it is difficult and often performed in suboptimal conditions leading to high rates of patient complications. Undetected misplacement in the esophagus is a preventable complication that can lead to fatalities in 5–10% of patients who undergo emergency intubation. End-tidal carbon dioxide monitoring and other proper placement detection methods are useful, yet the problem of misplacement persists. Our previous work demonstrated the utility of spectral reflectance sensors for differentiating esophageal and tracheal tissues, which can be used to confirm proper endotracheal tube placement. In this study, we examine the effectiveness of spectral characterization in the presence of saline, blood, “vomit”, and soot in the trachea. Our results show that spectral properties of the trachea that differentiate it from the esophagus persist in the presence of these substances. This work further confirms the potential usefulness of this novel detection technology in field applications.
Highlights
A fundamental step in front-line emergency medical care is ensuring patient oxygenation.The most common procedure to secure a patient’s airway is endotracheal intubation (ETI), in which an endotracheal tube (ETT) is inserted and secured in the trachea
We have demonstrated that these spectral signatures continue to differentiate between esophageal and tracheal tissues in vivo under hypoxic conditions [12]
We evaluated the capabilities of a novel biosensor for detecting proper ETT placement during ETI
Summary
A fundamental step in front-line emergency medical care is ensuring patient oxygenation.The most common procedure to secure a patient’s airway is endotracheal intubation (ETI), in which an endotracheal tube (ETT) is inserted and secured in the trachea. Caregivers face a variety of challenges when attempting ETI, including the difficulty of the procedure itself, environmental variables, patient condition and presentation, as well as obstructive anatomical features of the patient These challenges increase the rate of failed intubations resulting in patient complications up to and including death [1,2]. Patient anatomy, injuries such as maxillofacial trauma, swelling, hemorrhage, and other environmental contaminants can increase the difficulty of visualization in as much as 50% of cases in the prehospital setting [3,4] Due to these difficulties, an array of complications may arise including, hypoxia, hypotension, as well as cardiac arrest resulting from failed intubations [2,5]
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