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Respiratory & Airway Part Seven

Combitube: ET tube and a large pharyngeal tube molded together

  • Easy insertion
  • Blind, no equipment needed, don’t need to see cords
  • Patient’s head in neutral position
  • Ventilate the correct tube once in position
  • Self-adjusting/positioning posterior pharyngeal balloon
  • Diminished gastric distension and regurgitation
  • No face seal needed Disadvantages:
  • Can’t seal trachea
  • Only use on unconscious adults
  • Difficult to intubate around Containdications
  • Never use in a responsive patient with a gag reflex
  • No patient under 4 feet tall
  • No patient who ingested a caustic substance or with esophageal disease

Pharyngotracheal Lumen Airway: two-tube, two-cuff system

  1. Short, wide tube with large cuff
  2. Longer tube travels through the first, extending past the distal end No matter where each tube lies, the patient can still be ventilated
  • Easy insertion
  • Blind, no equipment needed, don’t need to see cords
  • Patient’s head in neutral position
  • Ventilate the correct tube once in position
  • Can occlude esophagus
  • Diminished gastric distension and regurgitation
  • No face seal needed Disadvantages:
  • Hard to identify tube location
  • Tissue tearing
  • Aspiration of blood/vomit in upper airway
  • Balloon can displace
  • Adults only
  • Oral use only
  • Extremely difficult to intubate around Containdications
  • Never use in a responsive patient with a gag reflex
  • No patients under 16 yo
  • No patient under 5 feet tall or over 6’7”
  • No patient who ingested a caustic substance or with esophageal disease

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