Experts in emergency medicine and ultrasound have teamed up at the University of Rochester to better one of the most vital tools in the paramedic's array of equipment: endotracheal tubes, the flexible tubes inserted in the throats of hundreds of thousands of unconscious patients each year to ensure continuous delivery of oxygen to their lungs. The new device, soon to receive a U.S. patent, takes advantage of the same ultrasound technology now used by physicians to observe babies developing in the womb.
Endotracheal tubes are relied upon by thousands of doctors, surgeons, and ambulance crews every day, but today's devices sometimes do more harm than good. Amid distractions like sirens and flashing lights, dangerous debris, and the cries of victims, rescuers can actually cause life-threatening complications by unwittingly inserting the tube in a patient's esophagus rather than the trachea, sending oxygen to the stomach instead of the lungs. Most experts estimate this occurs in 2 to 5 percent of patients, though a few doctors have suggested that the problem is much more common. If they're not found and corrected, such errors can lead not only to insufficient ventilation but also to stomach rupture, airway trauma, irreversible damage to the heart or brain, or even death.
The new endotracheal tube sidesteps these perils with "smarts" derived from ultrasound transducers smaller than a pencil's eraser -- miniature versions of the transducers in ultrasound scanners currently used by doctors to monitor fetal development, cardiac disease, and tumors. These transducers, which are attached to the lower end of the foot-long tubes, emit ultrasonic pulses that are detected by a small receiver on the front of the patient's neck only if the device is correctly inserted.
"This development takes advantage of human anatomy as well
as one of the fundamental properties of ultrasonic waves -- that
they don't travel through air," says Jack Mottley, associate
Contact: Steve Bradt
University of Rochester