A survey of the use of capnography for the confirmation of correct placement of tracheal tubes in pediatric intensive care units in the UK

Background: The Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland recommend the use of capnography to ensure correct tracheal tube placement in the theater environment. Correct tracheal tube placement is essential in the care of ventilated patient, even more vital if the patient is critically ill, if serious morbidity and mortality is to be avoided. This survey examined the availability and use of capnography to confirm correct tracheal tube placement in the pediatric intensive care unit (PICU) in the UK. Methods: A questionnaire concerning the use of capnography to confirm tracheal tube placement were sent to the lead clinicians of every PICU in the UK. Results: A total of 19 replies were received from 26 (73%) consultants. One unit did not have a capnograph, 13 units (68%) had one capnograph for several beds and five units (26%) had one capnograph for each bed. Two units (11%) used capnography for every intubation and in 10 units (52%) the use of capnography was dependent on individual physician preference. Eight consultants (42%) felt that confirming tracheal tube placement by capnography should be mandatory after every intubation whether in the ward, A & E, or PICU. A total of 89% of PICUs have trainees with < 1 year anesthetic experience compared with 65% of adult ICUs. Conclusions: The use of capnography to confirm tracheal tube placement may be even more important in the PICU than in adult ICU.