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. 2022 Jan;21(1):85-89.

Presentation of Two Simple Methods to Confirm Proper Tracheal Intubation: Palm Pressure, Plastic Bag Inflation, and Bag Pulsation

Zahid Hussain Khan  1 , Mojgan Rahimi  1 , Kamran Mottaghi  2 , Masoud Nashibi  2
Affiliations

Presentation of Two Simple Methods to Confirm Proper Tracheal Intubation: Palm Pressure, Plastic Bag Inflation, and Bag Pulsation

Zahid Hussain Khan et al. Tanaffos. 2022 Jan.

Abstract

Background: The correct placement of the endotracheal tube is a cornerstone of safe anesthesia. Different methods, such as auscultation, capnography, and ultrasound, have their own limitations regarding the confirmation of endotracheal intubation, reinforcing the idea that a single technique is not foolproof. This study proposes a new technique in this regard.

Materials and methods: A total of 600 patients were enrolled in this study, and tracheal intubation was checked with palm pressure and disposable plastic glove inflation and pulsation.

Results: The data were analyzed using the t-test and Mann-Whitney U test that indicate 94% and 94.8% sensitivity for palm pressure and bag pulsation, respectively, and a 100% positive predictive value for both tests.

Conclusion: Palm pressure and bag pulsation are accurate, inexpensive, and reliable techniques to confirm proper tracheal intubation.

Keywords: Bag inflation; Bag pulsation; Palm pressure; Tracheal intubation.

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Conflict of interest statement

Conflict of interest The authors declare no competing interests.

Figures

Figure 1.
Figure 1.
Finger of disposable transparent clear non sterile plastic glove has been attached and sealed around the tracheal tube at its proximal end.
Figure 2.
Figure 2.
Palm pressure applied on chest wall at right mid clavicular line on 5th intercostal space and plastic glove inflation evaluated.
See this image and copyright information in PMC

References

    1. Rajan S, Surendran J, Paul J, Kumar L. Rapidity and efficacy of ultrasonographic sliding lung sign and auscultation in confirming endotracheal intubation in overweight and obese patients. Indian J Anaesth 2017;61(3):230–4. - PMC - PubMed
    1. Heidegger T, Heim C. Esophageal detector device: not always reliable. Ann Emerg Med 1996;28(5):582. - PubMed
    1. Wright RS, Burdumy TJ. Acute endotracheal tube occlusion caused by use of an esophageal detector device: report of a case and a discussion of its utility. Ann Emerg Med 2004;43(5):626–9. - PubMed
    1. Cumming C, McFadzean J. A survey of the use of capnography for the confirmation of correct placement of tracheal tubes in pediatric intensive care units in the UK. Paediatr Anaesth 2005;15(7):591–6. - PubMed
    1. Verification of Endotracheal Tube Placement . Ann Emerg Med 2016;68(1):152. - PubMed

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