PMID: 9529185Apr 7, 1998Paper

Failed rapid sequence intubation in trauma patients: esophageal tracheal combitube is a useful adjunct

The Journal of Trauma
P A BlosteinS Hoak

Abstract

To characterize the use of the esophageal tracheal combitube (ETC) in trauma patients who fail orotracheal rapid sequence intubation (RSI). Prospective protocol design and retrospective chart review. Flight nurses were trained in the use of the ETC by mannequin simulation, videotape review, and didactic sessions. ETC insertion was attempted after failure of two or more attempts at orotracheal RSI. Over a 12-month period, 12 patients had ETC insertion, and 10 cases qualified for review. Injuries, number of failed orotracheal RSI attempts, definitive airway, initial arterial blood gas results, and outcome were recorded. ETC insertion was successful in all 10 patients in whom it was attempted. Definitive airway control was achieved by conversion to orotracheal intubation in seven patients, emergency department cricothyroidotomy in one patient, and operative room tracheostomy in two patients. No patient died because of failure to control the airway. Seven patients requiring ETC had mandible fractures. ETC insertion is an effective method of airway control in trauma patients who fail orotracheal RSI. It may be particularly useful in the patient with maxillofacial trauma and offers a practical alternative to surgical cricothyroidotom...Continue Reading

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Citations

Jul 12, 2003·The Journal of Trauma·C Michael DunhamUNKNOWN EAST Practice Management Guidelines Work Group
Mar 2, 2006·The Journal of Trauma·Joseph V PortereikoReuven Rabinovici
Oct 6, 2006·Current Opinion in Anaesthesiology·David C Kramer, Gerald Grass
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Sep 3, 2010·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Michael W HubbleRandall W Benner
Feb 7, 2018·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Jacinta WaackKaren Smith
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Jun 9, 2009·Journal of Clinical Anesthesia·Nicholas C LamLisa M Bassili

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