Authors: Bula-Bula M, N’sinabau R, Kabuni P, Nkoy B, Ndjoko S, Lenge N, Ngalala M, Ilunga JP.
Esophageal intubation is a common accident and failure to detect it can result in fatality. The objective of this study is to suggest the primary the auscultation of the epigastric area as mean of rapid diagnosis of esophageal intubation. A cross sectional study was carried out at the N’djili hospital in Kinshasa from June to September 2020.
The sampling was randomly made and two groups of the population were selected. In the study group, the endotracheal intubation was indirectly confirmed by the absence of borborygmi on auscultation of the of epigastric area whereas in the control group, it was confirmed by the presence of vesicular murmur in armpits.
After intubation, the investigator counted the time from the moment the chest piece of the stethoscope was placed in the armpit to confirm tracheal intubation or on the epigastric area to rule out esophageal intubation. The chest compression was also performed to check fogging of endotracheal tube. The time counted was the time between the placement of the chest piece of the stethoscope and the diagnosis of esophageal intubation.
Seven cases of esophageal intubation were recorded out of sixty-two patients intubated. The average time for diagnosing esophageal intubation was 15 ± 5.6 seconds in the study group and 24 ± 3.2 seconds in the control group (Z= 8.035; p < 0.0001).
Based on the time recorded, the primary auscultation of the epigastric area can quickly detect esophageal intubation as opposed to the auscultation of the armpit. “The sign the cross” could be used as chronogram to confirm tracheal placement of the tube.