The oesophageal detector device

as the first. was placed in the oesophagus. A further 5 ml air was injccted briskly into the tracheal tubc. with the oesophageal tube still deflated, and the front of the neck palpated. This cuff was then returned to its previous state and 5 ml air injected into the oesophageal tube, again while palpating thc front of thc neck. Finally, the cuff of the tracheal tube was deflated completely and the oesophageal tube tcstcd as before with 5 ml air. It was possible to detect a response to the injection of air in all cases by palpation of the front of the neck. It made no obvious differcncc whcthcr thc tracheal tubc cuff was inflated or otherwise, to what was felt when the oesophageal tube was inllated. A clear lateralised pulsation was found in 5/25 by which discrimination between the two tube locations would be possible. The only differences notcd in the remaining cascs was in 4/25 where thc ocsophageal test caused a more easily palpated pulsation, presumably because of the thinner wall of the oesophagus. Cuff inflation inay stop gas leaking round a tube placed in the oesophagus.J Stirt in 1982 reported a case where the cuff was considered to be palpable at the sternal notch but oesophageal misplaccment was diagnosed subsequently." Thc authors agree that cuff palpation i s a good indicator of the level o f descent of the tracheal tube and that i t may be useful to avoid intubation of a mainstcni bronchus. At the same tinic, the cvidcnce presented suggests that i t should be considered a poor test about the location of a tube.