New Airway's 'Smarts' Ensure That Patients Get Plenty...( fessor of electrical engineering. If a...)

fessor of electrical engineering. "If a transducer-equipped endotracheal tube is accidentally placed in the esophagus, the ultrasonic wave it emits won't reach a receiver mounted on the front of the throat. That's because the esophagus is located behind the trachea in the neck, and the ultrasonic wave is blocked by the air in the trachea."

In tests on human cadavers, Mottley and collaborator Randy Lipscher, a former resident in emergency medicine at Rochester now affiliated with several hospitals in the Austin, Tex., area, found that their design can also serve to pinpoint the location of the end of the endotracheal tube within the trachea -- a critical concern. "If the lower end of the tube is just a half- inch too deep in the trachea, only one lung will receive oxygen," Mottley says. "But if our endotracheal tube shifts within the trachea, you'll know immediately, because the ultrasonic signal will no longer reach the receiver."

The Rochester airway is the first to offer continuous monitoring of its own location within the trachea. A green light on the system's hand-held battery-powered unit indicates that the endotracheal tube is correctly inserted in the trachea, and an alarm sounds if the tube shifts too much within the trachea at any time during treatment or transport to the hospital.

"Some patients are intubated by anesthetists in the O.R. before an operation, and in this quiet, well-lit setting, faulty intubation is rare," says Linda Spillane, an assistant professor of emergency medicine at Rochester. "But much more often it's done by paramedics in the field -- a noisy, uncontrolled setting where intubation may be greatly complicated by patients who are bloody or vomiting, or who have trauma to the face or throat. There's also sufficient jostling en route to the hospital to dislodge even the sturdiest airway."

Emergency care providers and anesthetists have become increasingly attuned to the pitfalls of intubation in recent yea
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Contact: Steve Bradt
sbradt@admin.rochester.edu
716-273-4726
University of Rochester
8-May-1998

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