To improve the performance of EBs, our group proposed to deliberately pass the ETT tip distally to almost touch the carina and deflect the EB balloon sideways through the Murphy eye, and have used this technique on small children with apparent success (7).
The EB was 'pre-inserted' into the ETT lumen via the Coopdech ETT connector before intubation (Figure 1); the EB balloon tip was made to emerge through the Murphy eye and the catheter was then locked at the proximal end with the blocker tube clamp (equivalent to the Tuohy-Borst type valve on the Arndt multiport adaptor).
Her laryngoscopic view was Cormack and Lehane grade 2b in spite of cricoid pressure, and initial attempts at intubation with an 8 mm ID ETT 'pre-loaded' with an intraluminal 9 Fr Coopdech catheter emerging through the Murphy eye failed.
Instead of changing to a DLT, we simply made sure that the ETT Murphy eye was facing the right, advanced the ETT to a depth just before loss of bilateral ventilation and then advanced blindly a 9 Fr Coopdech with its tip angling to the right until it emerged through the Murphy eye (a subtle resistance followed by a 'give' was felt).
Making the balloon emerge through the Murphy eye makes accidental blockade of the ETT tip even more unlikely.
Rapi-Fit adapters (15 mm Luer lock),Anaesthesia Face Mask (Carbonized Rubber),"Anaesthesia Face Mask (PVC),Catheter Mount - 175 mm, Expandable with Luer sampling port,Closed Ventilation suction catheter system size 14Fr & 12 Fr for ET Tube suction,Double lumen tracheal-broncheal tube Right sided (PVC with tracheal and broncheal cuff),Double lumen tracheal-broncheal tube Left sided (PVC with tracheal and broncheal cuff),ET tube (PVC),ET tube (PVC) soft, cuffed with murphy eye
,ET tube (PVC), soft Non-cuffed with murphy eys Size 2.
We removed the assembly and introduced the fibrescope through the Murphy eye
but encountered the same problem.
We suggest using a normal adult endotracheal tube with a Murphy eye for initial training in the control of the rotation of the fibrescope.
The fibrescope can then be advanced from the machine's end and the trainee tries to exit via the Murphy eye using a rotation movement.
Tenders are invited for Supply of Common items-Oxygen Mask with Nebulizer- Adult,HME Filter,ET Tube (PVC) cuffed - Murphy eyes
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Eager Murphy eyes
title The apprentice jockeys' championship is the aim of Michael Murphy this year and he extended his lead at the top of the table with victory aboard Albonny in the 2m handicap.
TAKING HIS CUE: Sean Murphy eyes
a pot on his way to a final date with Marco Fu