The Endotracheal tube is an airway management device used in both emergency and surgical medicine settings. Depending on manufacturer, an ET tube ranges from twenty four to twenty seven centimeters in length and varies in width per patient age, size, and gender. The distal end is fitted with a universal adapter for a bag valve mask connection and pilot balloon that indicates cuff inflation at the proximal end. The opposite end has two openings, one directly at the end of the device and another just up the shaft in the side. This allows for airflow if the proximal opening becomes occluded with a foreign object or bodily substance The device itself is flexible to certain extent, light weight, and sterile when first out of packaging.
Placement of the airway requires a mix of precision, anatomic knowledge, and hours of training. For the purpose of this essay, the description of the EMT placement will be in accordance with the author’s local medical protocols and performed on a pulseless and apneic (not breathing) patient. The EMT first adheres to body isolation precautions with use of surgical mask, goggles, and gloves. The patient is placed into a “sniffing” position with the nose pointing up and opens the mouth by pushing gently on the mouth. The correct tube size is selected, a plastic covered wire is inserted inside the tube for added structural support...
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... drawbacks to combitube than the traditional ET tube. The risk of tooth trauma is present but more importantly over inflation of the distal cuff can cause trauma to the mouth can create hemorrhaging. The larger cuff shunts off the stomach blocking emesis. Most importantly the time it takes to intubate is signifigantly less than the prior but oxygenation of the patient, though adequate enough, is less than that of a tracheal intubation.
Both tools have been sanctioned and accepted by national committees, boards, and medical facilities abroad and are a vital part of a patient’s emergency and hospital care. From a personal view, use of either comes down to personal preference and the situation at hand. Many protocols call for endotracheal tubed intubation before the use of a combitube, but it comes down to personal preference and the patient laying in front of you.
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