Airway - Combitube

Airway - = Combitube

<= span style=3D'font-size:10.0pt;mso-bidi-font-size:12.0pt;font-family:Arial'>Clin= ical Indications:

______ 1. In an apneic patient = when endotracheal intubation i= s not possible or not available.

______ 2. Pati= ent must be &= #8805; 5 feet, ≤ 7 feet, and ≥ 16 years of age.

______ 3. Patient must be unconscious.

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<= span style=3D'font-size:10.0pt;mso-bidi-font-size:12.0pt;font-family:Arial'>Cont= raindications:

______ 1. Esophageal varices

______ 2. Ingestion of caustic substances

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<= span style=3D'font-size:10.0pt;mso-bidi-font-size:12.0pt;font-family:Arial'>Proc= edure:

______ 1. Preoxygenate and hyperventilate the patient.

______ 2. Prepare and lubricate the tube. Check both balloons.

______ 3. Grasp the patient’s tongue and jaw with your gloved hand and pull forward.

______ 4. Gently insert the tube until the teeth or gums are between the printed rings.

______ 5. Inflate cuff #1 (blue pilot balloon) with 100cc of air.

______ 6. Inflate cuff #2 (white pilot balloon) with 15cc of air.

______ 7. Ventilate taller blue tube (#1) with bag valve ma= sk.

______ 8. Auscultate for breath sounds and sounds over the epigastrium.<= o:p>

______ 9. Look for rise and fall of chest.

______ 10. If breath sounds are positive and epigastric sounds are negative, continue to ventilate through the blue tube. The tube is in the esophagus.

______ 11. Such case above allows you to aspirate stomach contents through the #2 white tube to relieve so= me gastric distention.

______ 12. If breath sounds are negative and epigastric sounds are positive, attempt to ventilate through the shorter white (#2) tu= be and assess for breath sounds and epigastric sounds. If breath sounds are present and epigastric sounds are absent, conti= nue to ventilate through the white tube (#2), you have intuba= ted the trachea.

______ 13. The device is secured in place by the large pharyngeal balloon.

______ 14. Confirm tube placement by using an end-tidal CO2 detector or esophageal bulb device.

______ 15. Endo= tracheal intubation with a combi-t= ube in place:

______ 16. The tube must be in the esophageal mode.

______ 17. Prepare all equipment needed for endotracheal intubation.

______ 18. Decompress the stomach by aspirating through the shorter, white tube (#2).

______ 19. Hyperoxygenate the patient.

______ 20. Deflate the bulbs on the Com= bi-tube and remove Combi-tube. Suction equipment should be ready.=

______ 21. Rapidly proceed with endotra= cheal inubation.

______ 22. Document procedure, confirmation, patient respons= e, and any complications in the electronic PCR.

<= span style=3D'font-size:10.0pt;mso-bidi-font-size:12.0pt;font-family:Arial'>Cert= ification Requirements:

Succ= essfully complete a biannual evaluation including the indications, contraindications, technique, and possible complications of the procedure.