Most of the cases with HNP are reported following orotracheal intubation, laryngeal mask airway (LMA) placement, Combitube
insertion (5) and bronchoscopy (6).
(6-8,10,11) The classical LM (6-8,53) and the combitube
are the most supported, (9,17,22,25,54) though the latter tends to be more traumatic and limited to patients over 120 cm in height.
Complications following the use of the Combitube
, tracheal tube and laryngeal mask airway.
Alternative airway devices can include extraglottic devices [laryngeal mask airway (LMA), intubating laryngeal mask airway (ILMA), Combitube
, etc.], fiber optic systems, video laryngoscopes, and sur gical airway equipment (10-14).
Comparison of endotracheal intubation, combitube
, and laryngeal mask airway between inexperienced and experienced emergency medical staff: A manikin study.
In this situation either we have to use the alternative airway devices like LMA or combitube
but if these fail then the final choice is to proceed for Emergency Surgical Airway Access4,5.
Retrograde intubation around an in situ combitube
: a difficult airway management strategy.
A comparison of the proseal laryngeal mask airway, the laryngeal tube S and the oesophageal-tracheal combitube
during routine surgical procedures.
(5,10) An alternative device is the oesophageal-tracheal combined tube (Combitube
), which not only provides a reliable seal against regurgitation, but also allows effective positive pressure ventilation; it can be used as a conduit for secondary tracheal intubation and placement in either oesophagus or trachea will allow ventilation.
in elective surgery: A report of 200 cases.
The basic emergency medical technician has the same capability as the 1st responder and can provide additional airway support with an invasive Combitube
Esophageal tracheal Combitube
in the emergency department.