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Advanced Airway Management COMBITUBE. Adjunctive Airways Endotracheal Intubation – ET Esophageal Obturator airway – EOA Esophageal gastric tube airway.

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Presentation on theme: "Advanced Airway Management COMBITUBE. Adjunctive Airways Endotracheal Intubation – ET Esophageal Obturator airway – EOA Esophageal gastric tube airway."— Presentation transcript:

1 Advanced Airway Management COMBITUBE

2 Adjunctive Airways Endotracheal Intubation – ET Esophageal Obturator airway – EOA Esophageal gastric tube airway – EGTA

3 Complications With EOA\EGTA Esophageal rupture Gastric rupture Endotracheal intubation Bag-valve-mask ventilation

4 Combitube Ventilation in either esophageal or endotracheal position Blind placement No patient neck movement

5 Lumen #1 - esophageal obturator lumen Lumen #2 - tracheal lumen Pharyngeal balloon Esophageal cuff – distal balloon Combitube - Design

6 Combitube

7 Indications Endotracheal intubation cannot be done Endotracheal intubation unsuccessful Limited patient access High risk for c-spine injury

8 Contraindications Less than 16 years old Less than five (5) feet tall Intact gag reflex Known esophageal disease Caustic ingestion

9 Procedure Start CPR, oxygen and defibrillation Check Combitube balloons for leaks Lift lower jaw and tongue Insert Combitube following curve of the pharynx Stop when black rings line up with upper teeth or alveolar ridge

10 Procedure – Cont. Inflate blue pilot balloon with 100 cc of air Inflate white pilot balloon with 10-15 cc of air Ventilate using longer blue tube – No. #1 Listen for breath sounds, if none … Switch to the shorter clear tube – No. #2 Recheck breath sounds

11 Other Information Oxygen saturations similar Caution when giving drugs Skills maintenance requirements

12 Summary Rapid, effective airway management Ease of insertion Airway is self-anchored Posterior balloon protects from oral secretions Posterior balloon can be deflated for visualization during endotracheal intubation

13 Summary –Cont. Posterior balloon protects from oral secretions Posterior balloon can be deflated for visualization during endotracheal intubation Gastric contents can be suctioned

14 Combitube


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