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In recent studies, 9% to 25% of intended endotracheal intubations performed by emergency medical services personnel were unrecognized esophageal intubations (JWEM Mar 21 2001and JWEM Sep 24 2003). In this study, researchers evaluated misplacement rates in a prospective study of 208 consecutive patients who were intubated nasotracheally or orotracheally by paramedics (without rapid sequence intubation drugs) and brought to two trauma center emergency departments in Indianapolis. On patient arrival, emergency physicians verified tube placement using a combination of direct visualization, colorimetric ETCO2 detectors, esophageal detector devices, and physical examination. Paramedics were aware that the study was being performed.
Tube placement …