Effectiveness of the Self-Inflating Bulb for Verification of Proper Placement of the Esophageal Tracheal Combitube Registered Trademark

Wafai, Yaser; Salem, M. Ramez; Baraka, Anis; Joseph, Ninos J.; Czinn, Edward A.; Paulissian, Robert

doi:10.1213/00000539-199501000-00021

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…6). The device is also inserted blindly, and the upper and lower elastic balloons inflated 11 . The esophagus and oropharynx are completely obliterated, allowing the ventilation perforations between the two obturator balloons to ventilate the trachea.…”

Section: Methodsmentioning

confidence: 99%

Lost Airway During Anesthesia Induction: Alternatives for Management

1997

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Pediatric and adult patients with upper airway obstruction pose several challenges to the anesthesiologist and otolaryngologist--head and neck surgeon. The initiation of general anesthesia and endotracheal intubation may progress to complete life-threatening respiratory decompensation with failure to achieve endotracheal intubation or mask ventilation. Hurried invasive maneuvers such as large-bore needle tracheal entry and cricothyrotomy are recognized salvage techniques, but other modes of extratracheal ventilation are now possible before surgical airway procedures are required. The laryngeal mask airway and esophagotracheal Combitube (Kendall Sheridan Health Care Products Co., Argyle, NY) are described, with examples of their clinical application. The combined technique of anterior commissure laryngoscopy and intubation with the gum elastic bougie is the preferred alternative for achieving tracheal entry when extratracheal ventilation cannot be accomplished. An algorithm for joint management of the problem airway by anesthesiologist and otolaryngologist--head and neck surgeon is illustrated.

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Section: Methodsmentioning

confidence: 99%

Lost Airway During Anesthesia Induction: Alternatives for Management

1997

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“…Although the 2nd generation SADs have many desirable features, they are, nevertheless, inserted in the same 'blind fashion' as the 1st generation devices, based on educated guesses about correct placement, appropriate device size and insertion depth. Clinicians still rely on a range of subjective indirect assessment and clinical tests (Table 1), dedicated to the simple task of correct placement of a single device [37][38][39][40][41][42][43][44]. This plethora of tests should alert clinicians that 'all is not well inside the camp'.…”

Section: Why the Need For Sad Placement Under Direct Vision?mentioning

confidence: 99%

The case for a 3rd generation supraglottic airway device facilitating direct vision placement

Zundert

Kumar

Zundert

et al. 2020

J Clin Monit Comput

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Although 1st and 2nd generation supraglottic airway devices (SADs) have many desirable features, they are nevertheless inserted in a similar 'blind' way as their 1st generation predecessors. Clinicians mostly still rely entirely on subjective indirect assessments to estimate correct placement which supposedly ensures a tight seal. Malpositioning and potential airway compromise occurs in more than half of placements. Vision-guided insertion can improve placement. In this article we propose the development of a 3rd generation supraglottic airway device, equipped with cameras and fiberoptic illumination, to visualise insertion of the device, enable immediate manoeuvres to optimise SAD position, verify whether correct 1st and 2nd seals are achieved and check whether size selected is appropriate. We do not provide technical details of such a '3rd generation' device, but rather present a theoretical analysis of its desirable properties, which are essential to overcome the remaining limitations of current 1st and 2nd generation devices. We also recommend that this further milestone improvement, i.e. ability to place the SAD accurately under direct vision, be eligible for the moniker '3rd generation'. Blind insertion of SADs should become the exception and we anticipate, as in other domains such as central venous cannulation and nerve block insertions, vision-guided placement becoming the gold standard.

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“…As the Combitube is a double lumen tube and can enter either the trachea or oesophagus, it is imperative that ventilation occurs through the correct lumen. As with the tracheal tube, the gold standard is identification of CO 2 in expired gas, but the oesophageal detector device described by Wee has recently been shown to be effective (Wafai et al, 1995).…”

Section: Limitations Of the Combitubementioning

confidence: 99%

Airway management: the difficult airway

Bryden

Gwinnutt

2000

Trauma

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Maintenance of a patent airway to allow ventilation with high concentration oxygen is an essential procedure during the resuscitation of all trauma patients. A range of equipment is available to help achieve and maintain a clear airway, with endotracheal intubation remaining the gold standard. However, in trauma patients attempts at intubation are often impeded by the presence of associated injuries and the application of devices to immobilize the cervical spine. In the situation of ‘can’t ventilate, can’t intubate’ a surgical airway can be life-saving while expert help is sought. Recently, new devices, in particular the laryngeal mask airway and Combitube®, have gained recognition as having a role in difficult airway management when other methods have failed, thereby reducing the need for surgical intervention. This paper presents an overview of the currently accepted methodology of managing the difficult airway in the trauma patient.

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Effectiveness of the Self-Inflating Bulb for Verification of Proper Placement of the Esophageal Tracheal Combitube Registered Trademark

Cited by 5 publications

References 12 publications

Lost Airway During Anesthesia Induction: Alternatives for Management

Lost Airway During Anesthesia Induction: Alternatives for Management

The case for a 3rd generation supraglottic airway device facilitating direct vision placement

Airway management: the difficult airway

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