A trial of the Nellcor Stat Cap, which detects exhaled carbon dioxide, as an aid to determining whether endotracheal tubes are placed in the oesophagus or the trachea, was carried out in the neonatal unit of this hospital. Twenty five neonates, with a mean (range) gestational age of 33 (24-42) weeks and a mean (range) birthweight of 2.17 (0.54-4.1) kg were studied over two months. These babies underwent a total of 58 intubations and 20 suspected self-extubations. The Nellcor Stat Cap was easy to use. It confirmed clinical findings on 20/20 occasions when the endotracheal tube was in the oesophagus and on 57/58 (98%) occasions when it was in the trachea. On 14/78 (19%) occasions the machine provided helpful additional information in reaching a decision on the adequacy of tube placement. Failure to detect rapidly accidental oesophageal intubation or unintentional tracheal extubation can result in rapid deterioration of the condition of ventilated newborns. The machine is a valuable aid to intubation and rapid diagnosis of self-extubation.
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