How do you use Combitube?

When using a Combitube®, inflate the distal balloon first using 10 to 15 mL, then inflate the proximal (pharyngeal, blue) balloon using 50 to 85 mL. Connect a bag-valve apparatus to the ventilating lumen (on the Combitube®, the blue [pharyngeal] lumen).

How do you inflate a Combitube?

Where is the Combitube inserted?

A Combitube is composed of dual tubes and can be inserted into the esophagus or trachea without using a laryngoscope. It can easily maintain the airway, whether it is inserted into the esophagus or the trachea [9]. Normally without a laryngoscope, a Combitube inserts into the esophagus in more than 80% of cases.

What are two contraindications for the use of a Combitube?

Contraindications to use of the esophageal tracheal Combitube use include esophageal obstruction or other abnormality, ingestion of caustic agents, upper airway foreign body or mass, lower airway obstruction, height less than 4 feet, and an intact gag reflex.

What are the indications for a Combitube?

The major indication of the ETC is as a back-up device for airway management. It is an excellent option for rescue ventilation in both in- and out-of-the-hospital environments and in situations of difficult ventilation and intubation.

What is esophageal Combitube?

The esophageal tracheal combitube (ETC) is a supraglottic airway device that functions as an effective alternative to ventilation via mask and tracheal intubation and is therefore a valuable tool in difficult and emergency airway management.

When using the Combitube during intubation which Cuff do you inflate last?

If gurgling sounds are heard over the epigastrium, the Combitube is located in the esophagus. Inflate the proximal cuff with just enough air until either no leak is present or a subjective sensation of increased resistance to cuff inflation is encountered. This is usually achieved by inflating with 50-75 ml of air.

How does the King LT airway differ from the Combitube?

Both the King LT and Combitube are intended to have their distal tip placed in the esophagus. With the King LT the pharyngeal balloon and esophagus balloon are inflated through a single inflation port and pilot balloon, while the Combitube has two ports and pilot balloons.

Is a Combitube an endotracheal tube?

The Combitube is a useful alternative to endotracheal intubation when an airway is not obtained after multiple attempts, when the airway is considered a difficult one, when direct visualization of the vocal cords by laryngoscopy is not possible at the scene, or when prehospital providers are not trained to perform …

What are the size limitations of the Combitube?

The Combitube also has been used for routine anesthetic delivery44,45 and is available in two sizes: the 37 Fr size is for patients 120 cm to 180 cm in height, and the 41 Fr size is for patients taller than 180 cm.

Is Combitube a definitive airway?

Despite the documented success of the Combitube in difficult airway management, we prefer extraglottic devices that allow for the establishment of a cuffed endotracheal tube (ETT) in the trachea (ie, definitive airway). It is not possible to establish a definitive airway through the Combitube.

Is Combitube definitive airway?

What replaced the Combitube?

As a “blind” airway device, the King Airway has largely replaced the Combitube as the civilian and military SGA of choice due to its design and ease of use. However, over the past decade, there have been many other SGAs, particularly iterations of the laryngeal mask airway (LMA), that have come to market.

Why would you use a Combitube?