Articles: intubation.
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The technique of prehospital airway management is determined largely by the level of training and expertise of the prehospital care provider. We report preliminary observations and data in experimental animals and patients using a new airway adjunct--the pharyngeo-tracheal lumen (PTL) airway. The PTL airway employs a two-tube, two-cuff system that is inserted in a "blind" fashion. ⋯ Volumetric efficiency at optimal cuff inflation pressures was 100%, and arterial blood gas values obtained during PTL ventilation were not significantly different from those measured during ventilation with an endotracheal tube at comparable minute ventilations. In six arrest patients undergoing cardiopulmonary resuscitation, arterial PO2 and PCO2 using the PTL airway (176 +/- 105 mm Hg and 36 +/- 12 mm Hg, respectively) were not significantly different from those measured during artificial ventilation with an endotracheal tube (PO2, 162 +/- 124 mm Hg; PCO2, 34 +/- 10 mm Hg). Although the numbers are small, the data suggest that the PTL airway may be an alternative method of emergency airway management when endotracheal intubation cannot be performed.
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The use of a Tiemann curved tip urethral catheter for repeated nasotracheal suction in 120 instances of postoperative pulmonary complications was proved to be more efficient than the use of a regular suction catheter. The curved tip is better adapted to the anatomy of the nasotracheobronchial tract and allows easy selective catheterization of the trachea and major bronchi.
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Jpen Parenter Enter · Jul 1984
Case ReportsPneumothorax following attempted nasogastric intubation for nutritional support.
Nasogastric intubation is a routine procedure, performed daily by both medical and nursing staff. It is a simple procedure, but not without complications which can be life threatening. We present an unusual, life threatening complication which occurred when nasogastric intubation using a no. 8 polyurethane tube with its metal stilet resulted in a pneumothorax after intubation of the endotracheal tree in the presence of a cuffed endotracheal tube. We emphasize that the presence of a cuffed endotracheal tube should not be considered a safeguard against pulmonary intubation during nasogastric placement of a feeding catheter.
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Traumatic pneumothoraces in ventilated premature infants are mostly related to high applied airway pressures. We report five cases of pneumothorax after endotracheal tube suctioning that illustrate two different mechanisms by which this may occur. Following suggested preventive measures, such complications have not recurred.