Precut Endotracheal Tubes for Orotracheal Intubation

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 809-809
Author(s):  
GERALD H. KATZMAN
Keyword(s):  
Nasotracheal Intubation ◽  
Orotracheal Intubation ◽  
Additional Method ◽  
Endotracheal Tubes

Recently, I visited several neonatal units and delivery areas. I noted that the endotracheal tubes used for orotracheal intubation are of a length required for nasotracheal intubation. There is a line on the tube marked with the words "oral" on the side closer to the tip and "nasal" on the farther side. Various techniques have been recommended for managing endotracheal tubes in newborns. The use of endotracheal tubes, precut by the manufacturer for orotracheal intubation, represents an additional method that has several advantages.

Ventilator-associated pneumonias in children ( ii ) - prophylaxis and treatment

Folia Medica ◽  
2012 ◽  
Vol 54 (1) ◽  
pp. 12-18
Author(s):  
Tonyo Il. Shmilev ◽  
Ivan V. Yankov
Keyword(s):  
Staff Training ◽  
Protective Clothing ◽  
Nasotracheal Intubation ◽  
Orotracheal Intubation ◽  
Microbial Colonization ◽  
Resistant Bacteria ◽  
Ventilator Associated Pneumonia ◽  
Endotracheal Tubes ◽  
Antibiotics Sensitivity ◽  
The Right

ABSTRACT Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection among children treated in intensive care units. The risk factors for developing this condition are generated by the patient’s bedside conditions, the equipment used and the specifi c treatment administered to the child. Prophylaxis of VAP should necessarily include all measures that have been proven to be effi cient in this respect such as rigorous hygiene control of hands and protective clothing of attending staff, changing breathing circuits of ventilators only if they malfunction or if they are visibly contaminated, preference of orotracheal intubation (instead of nasotracheal intubation) and use of endotracheal tubes with dorsal lumens to allow respiratory secretions to drain, and introduction of a uniform approach to patient care and staff training. Prophylaxis of the microbial colonization in children by antibiotics does not reduce the incidence of VAP-causing poly-resistant bacteria. Therapeutic management includes early initiation of broad spectrum empirical antibiotic therapy, the right choice of antibiotic requiring regular monitoring and good knowledge of the antibiotics sensitivity of the most common microbial isolates in the ward.

Comparison among the Intubation Techniques Employed in the Course of Management of Pan-Facial Trauma

2021 ◽  
Author(s):  
Aravindh RJ
Keyword(s):  
General Anesthesia ◽  
Nasotracheal Intubation ◽  
Functional Results ◽  
Orotracheal Intubation ◽  
Facial Trauma ◽  
Minimal Risk ◽  
Intermaxillary Fixation ◽  
Intubation Technique ◽  
Submental Intubation ◽  
Intraoperative Period

Objective: To find the best method of intubation in patients sustaining pan-facial trauma by comparing the pros and cons of each technique. Materials and methods: Three different types of intubation techniques (nasotracheal intubation, orotracheal intubation, and sub-mental intubation) were considered in this study. The study population involves 9 patients who have undergone treatment for pan-facial trauma under general anesthesia (3 patients per technique) and the variables of clinical outcome of each group were recorded. Results: Nasal intubation is the most common and safest method of intubation. However, it can’t be used in some types of pan-facial trauma. In cases like these, oral intubation is not preferred. As it severely compromises maxillofacial repair because of interference with the placement of intermaxillary fixation [3](IMF), which is used to establish the patient s occlusion in the intraoperative period. Submental intubation is an alternative with minimal risk to tracheostomy when orotracheal or nasotracheal intubation is not appropriate. The submental intubation technique gave an uninterrupted surgical field, unobstructed airway, ease of gaining occlusion in general anesthesia, less intraoperative and postoperative complications and it overcomes the disadvantages of both nasotracheal and orotracheal intubation. Conclusion: Preferred techniques of securing an airway are orotracheal, nasotracheal intubation. However these techniques may not always be applicable, thus a trauma surgeon-anesthetist team should always have alternative techniques in their armamentarium which secures the patient's airways without interfering with occlusion, to gain at most postoperative esthetic and functional results.

scholarly journals 19. A Breathing Manikin Model for Teaching Nasotracheal Intubation to EMS Professionals

1996 ◽  
Vol 11 (S2) ◽  
pp. S39-S39
Author(s):  
Juan March ◽  
Kathleen Dunn ◽  
Lawrence Brown ◽  
Johnny Farrow ◽  
Phillip Perkins
Keyword(s):  
Nasotracheal Intubation ◽  
Prospective Trial ◽  
Rapid Sequence Induction ◽  
Training Session ◽  
Orotracheal Intubation ◽  
Rank Test ◽  
Post Intervention ◽  
Convenience Sample ◽  
Before And After ◽  
Signed Rank Test

Purpose: The wide spread use of orotracheal intubation with rapid sequence induction has made it difficult for EMS professionals to gain experience in nasotracheal intubation (NTI) in a controlled supervised setting. The purpose of this study was to determine if a training session on NTI with a breathing manikin can be used to improve skill and comfort of EMS professionals.Methods: A prospective trial was conducted with a convenience sample of 16 emergency medical service professionals, previously trained in nasotracheal intubation techniques. For the training session a Laerdal airway manikin was modified by replacing the lungs with a bag-valve mask device, to simulate breathing with an inspiratory and expiratory phase. Following verbal instruction, and with direct supervision, each participant practiced NTI using the breathing manikin. Each participant completed a questionnaire, both before and after the training session, to determine self assessed comfort and skill level for both oral and nasal intubations (0 = lowest, 10 = highest). The pre and post intervention scores were compared using the Wilcoxon signed-rank test, £ = 0.01.

Airway Control in Trauma Patients with Cervical Spine Fractures

1994 ◽  
Vol 9 (1) ◽  
pp. 44-49 ◽  
Author(s):  
S. Alan Lord ◽  
William C. Boswell ◽  
James S. Williams ◽  
John W. Odom ◽  
Carl R. Boyd
Keyword(s):  
Cervical Spine ◽  
Trauma Center ◽  
Nasotracheal Intubation ◽  
Vital Signs ◽  
Orotracheal Intubation ◽  
Cervical Spine Fracture ◽  
Trauma Patients ◽  
Airway Control ◽  
American College Of Surgeons ◽  
Surgical Airway

AbstractIntroduction:Proper airway control in trauma patients who have sustained cervical spine fracture remains controversial.Purpose:This study was undertaken to survey the preferred methods of airway management in cervical spine fracture (CSF) patients, to evaluate the experience of handling such patients at a level-I trauma center, and to contrast the findings with recommendations of the American College of Surgeons Committee on Trauma.Hypothesis:The methods used for control of the airway in patients with fractures of their cervical spine support the recommendation of the American College of Surgeons (ACS) Committee on Trauma.Methods:The study consisted of two parts: 1) a survey; and 2) a retrospective study. Survey questionnaires were sent to 199 members of the Eastern Association for the Surgery of Trauma and to 161 anesthesiology training programs throughout the United States. Three resuscitation scenarios were posed: 1) Elective airway—CSF—breathing spontaneously, stable vital signs; 2) Urgent airway—CSF—breathing spontaneously, unstable vital signs; and 3) Emergent airway—CSF—apneic, unstable. In addition, a three-year retrospective study was conducted at a level-I trauma center to determine the method of airway control in patients with cervical spine fractures.Results:Responses to the questionnaires were received from 101 trauma surgeons (TS) and 58 anesthesiologists (ANESTH). Respondents indicated their preference of airway methods: Elective airway: Nasotracheal intubation: TS 69%, ANESTH 53%. Orotracheal intubation: TS and ANESTH 27%. Surgical airway: TS 4%. Intubation with fiberoptic bronchoscope (FOB): ANESTH 20%. Urgent airway: Nasotracheal intubation: TS 48%, ANESTH 38%. Orotracheal intubation: TS 47%, ANESTH 45%. Surgical airway: TS 4%. FOB: ANESTH 16%. Emergent airway: Orotracheal intubation: TS 81 %, ANESTH 78%. Surgical Airway: TS 19%, ANESTH 7%. FOB: ANESTH 15%.The retrospective review at the trauma center indicated that 102 patients with CSF were admitted; 62 required intubation: four (6%) on the scene, seven (11%) en route, five (8%) in the emergency department, 42 (67%) in the operating room, and four (6%) on the general surgery floor. Airway control methods used were nasotracheal: 14 (22%); orotracheal: 27 (43%); FOB: 17 (27%); tracheostomy: one (2%); unknown: three (4%). No progression of the neurological status resulted from intubation.Conclusion:The choice of airway control in the trauma patient with CSF differs between anesthesiologists and surgeons. However, the method selected does not have an adverse affect on neurological status as long as in-line stabilization is maintained. The methods available are safe, effective, and acceptable. The recommendations of the American College of Surgeons Committee on Trauma for airway control with suspected cervical spine injury are useful. The technique utilized is dependent upon the judgment and experience of the intubator.

scholarly journals Pilot Study Comparing Nasal vs Oral Intubation for Dental Surgery by Physicians, Nurse Anesthetists, and Trainees

2018 ◽  
Vol 65 (2) ◽  
pp. 89-93 ◽  
Author(s):  
J. Patrick Bowman ◽  
Michael P. Nedley ◽  
Kimberly A. Jenkins ◽  
Charles R. Fahncke
Keyword(s):  
General Anesthesia ◽  
Dental Treatment ◽  
Nasotracheal Intubation ◽  
Orotracheal Intubation ◽  
Nurse Anesthetists ◽  
Radiographic Imaging ◽  
Dental Surgery ◽  
Physical Status Classification ◽  
Medicine Physician ◽  
Significant Difference

The purpose of this article was to determine if pediatric dental treatment under general anesthesia utilizing orotracheal intubation takes longer than using nasotracheal intubation techniques. Twenty-six American Society of Anesthesiologists Physical Status Classification I and II pediatric dental patients, ages 2–8 years treated under general anesthesia, were assigned to 1 of 2 groups: (a) nasotracheal intubation (control, n = 13), (b) orotracheal intubation (experimental, n = 13). Times for intubation, radiographic imaging, and dental procedures, as well as total case time were quantified. Data were collected on airway difficulty, numbers of providers needed for intubation, intubation attempts, and intubation trauma. There was a significant difference in mean intubation time (oral = 2.1 minutes versus nasal = 6.3 minutes; p < .01). There was no difference in mean radiograph time (oral = 4.2 minutes versus nasal = 3.4 minutes; p = .144), and overall radiograph image quality was not affected. There was no difference in dental procedure time (p = .603) or total case time (p = .695). Additional providers were needed for intubation and more attempts were required for nasotracheal intubation versus orotracheal intubation (6 additional providers/22 attempts vs 0 additional providers/15 attempts, p < .01 and p < .05, respectively). Nine of 13 nasotracheal intubations were rated as traumatic (69%) versus 0 of 13 for orotracheal intubations (0%) (p < .01). In 7/9 orotracheal intubation cases (78%), the tube was not moved during treatment (p < .01). Orotracheal intubation does not increase case time, does not interfere with radiographic imaging, and is less traumatic for the patient when performed by physician anesthesiologists, emergency and pediatric medicine physician residents, certified registered nurse anesthetists, and student nurse anesthetists, all with variable nasotracheal intubation experience.

scholarly journals Nasotracheal intubation for airway management during anesthesia

2021 ◽  
Vol 16 (3) ◽  
pp. 232-247
Author(s):  
Dong Ho Park ◽  
Chia An Lee ◽  
Chang Young Jeong ◽  
Hong-Seuk Yang
Keyword(s):  
Intensive Care ◽  
Airway Management ◽  
Nasotracheal Intubation ◽  
Maxillofacial Surgery ◽  
Orotracheal Intubation ◽  
Review Article ◽  
Oral And Maxillofacial Surgery ◽  
Nasal Airways ◽  
Surgical Field ◽  
Preventive Methods

Nasotracheal intubation is used as a basic method for airway management, along with orotracheal intubation under anesthesia and intensive care. It has become an effective alternative method to orotracheal intubation with increased benefits of offering better mobility and surgical field in oral and maxillofacial surgery and possibly in trauma and critically ill patients. Nasotracheal intubation is performed through a relatively narrow nasal cavity; therefore, additional precautions are needed. Accordingly, nasotracheal intubation methods have evolved over the years with accumulated clinical experience and improved instruments to facilitate safe intubation with reduced complications. Therefore, in this review article, we summarize the basic anatomy of the nasal airways to clarify the precautions, delineate the history and development of various methods and instruments, and describe the indications, contraindications, complications, and preventive methods of nasotracheal intubation.

scholarly journals Submental intubation in pediatric maxillofacial surgery: report of 2 cases

1969 ◽  
Vol 48 (2) ◽  
pp. 91-95
Author(s):  
Vanessa Alejandri-Gamboa ◽  
Pedro J. Téllez-Rodríguez ◽  
María C.R. López-Fernández ◽  
Abel Sanjuan-Martínez ◽  
Lina Sarmiento
Keyword(s):  
Surgical Procedures ◽  
Current Literature ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Nasotracheal Intubation ◽  
Maxillofacial Surgery ◽  
Orotracheal Intubation ◽  
Morbidity And Mortality ◽  
Submental Intubation ◽  
Review Current

Submental intubation (SMI) is useful in surgical procedures where nasotracheal intubation is contraindicated and orotracheal intubation is not ideal, making it an alternative to tracheostomy since it is performed in less time, with less morbidity and mortality, minimal postoperatory care, as well as an aesthetically acceptable scar. We present 2 cases of pediatric patients with a successful SMI. In addition, we briefly review current literature regarding pediatric population.

Sign in / Sign up

Export Citation Format

Share Document