ABSTRACT
PURPOSE: The study was conducted to evaluate the usefulness of syringe aspiration technique (SAT) to correctly differentiate between esophageal and tracheal intubation in emergency department. METHODS: This study, which was comprised of a prospective series of cases, was conducted in the emergency department of an university hospital. A 50 mL catheter-tip syringe was attached to the end of the tracheal tube following intubation. The syringe plunger was then withdrawn or aspirated with 50 mL of air. The ability to withdraw air into the syringe without resistance and without syringe plunger rebound was considered evidence of tracheal intubation. If resistance was met as the syringe was aspirated or if the syringe plunger rebounded following aspiration, esophageal intubation was assumed. RESULTS: Seventy patients were enrolled in the study. Tracheal intubation was performed in 46 patients, and esophageal intubation was performed in 24 patients. Of the 46 tracheal intubations, the SAT correctly indicated tracheal placement in 45 and was indeterminate in 1 case because of blockage of the endotracheal tube by gastric material resulting from aspiration. All 24 esophageal intubation were corrected identified. CONCLUSION: This study suggests that the SAT is a safe and effective device for determining endotracheal tube position in patients with various clinical conditions requiring urgent airway control in the emergency department.