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Journal of Clinical Monitoring and Computing (2007) 21:155158DOI: 10.1007/s10877-007-9069-9 Springer 2007
Reicher D, Reicher J, Reicher M. Use of Radio Frequency Identication (RFID) tags in bedside monitoring of endotracheal tube position.
J Clin Monit Comput 2007; 21:155158
ABSTRACT. Improper positioning of the endotracheal tube during intubation poses a serious health risk to patients. In one prospective study of 219 critically ill patients, 14% required endotracheal tube repositioning after intubation [Brunel et al. Chest 1989; 96: 10431045] While a variety of techniques are used to conrm proper tube placement, a chest X-ray is usually employed for denitive verication. Radio frequency identication (RFID) technology, in which an RFID reader emits and receives a signal from an RFID tag, may be useful in evaluating endotracheal tube position. RFID technology has already been approved for use in humans as a safe and effective tool in a variety of applications. The use of handheld RFID detectors and RFID tag-labeled endotracheal tubes could allow for easy and accurate bedside monitoring of endotracheal tube position, once initial proper placement is conrmed.
KEY WORDS. radio frequency identication, RFID, RFID tag, endotracheal tube position, bedside monitoring endotracheal tube.
INTRODUCTION
Attempted endotracheal intubation can lead to a number of signicant problems, the two most serious being esophageal intubation and incorrect depth of insertion [1]. Early detection and correction of these problems is critical. In the case of esophageal intubation, exhaled phasic carbon dioxide is absent. This is easily detected with the use of disposable carbon dioxide measurement devices or continuous in-line monitoring of exhaled carbon dioxide[2]. As for determining the correct depth of insertion, a variety of bedside methods and X-ray imaging are employed [36]. Use of ballotability, commonly employed by anesthesiologists after induction of anesthesia, is not very practical in the ICU setting where this method could cause pain or unwanted elevations of blood pressure or intracranial pressure [3]. In addition, ballotability in the suprasternal notch may occur even with right mainstem intubation [7]. While X-rays remain the gold standard for conrmation of appropriate insertion depth, they are usually done only once per day [5, 6]. This may not be sufcient to detect tube migration that can frequently occur during patient care in the ICU. Caudal displacement has long been recognized as leading to...