Using the Self-Inflating Bulb to Detect Esophageal Intubation in Children

Several devices have been approved to aid in confirming endotracheal tube (ETT) placement. One such device, the self-inflating esophageal bulb, is approved for patients weighing more than 20 kg. The benefit of this device is that it can be used in nonperfusing patients. It works on the principle that if the ETT is in the rigid trachea and negative pressure is applied by compressing and then releasing the bulb, free aspiration of air occurs and the bulb rapidly reexpands. In the esophagus, soft tissues prevent rapid entry of air into the tracheal tube, and bulb reexpansion is delayed or absent. These authors assessed whether the device can be used reliably in children weighing more than 20 kg and compared 2 methods: compressing the bulb afte…