Category: Intubation

photo comparison of adult vs infant larynx

Should I Use A Cuffed or Uncuffed Endotracheal Tube In a Child?

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When intubating children, the question always arises whether to use a cuffed or an uncuffed endotracheal tube (ETT). Historically uncuffed endotracheal tubes have been used when the child is less than about 8 years old. Why is it that we can get away with using an uncuffed tube in a young child, but not an adult? The answer comes from the difference in airway anatomy between child and adult. Understanding the advantages and disadvantages of using uncuffed and cuffed tubes in children is important to safe patient care. Read More …

Tips for Mastering the LMA Fastrach

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The rare “can’t intubate-can’t ventilate” scenario is frightening. It’s important to master as many techniques as possible to prepare for this possibility. The LMA Fastrach is designed specifically designed to ventilate a patient intermittently during a prolonged intubation attempt. Knowing how to use this tool could potentially save a patient’s life. Using the Fastrach is not difficult. However, there are enough steps during intubation, as well as during safe removal of the device without accidental extubation, that can make it seem intimidating. In addition to some tips and tricks that make it work, you’ll find a link below to a video clip of intubating a patient with the Fastrach. Read More …

Embrace the Catastrophist Within: Protecting Ourselves From Respiratory Infection

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A good anesthesiologist, or any health care provider, has to embrace the catastrophist within because our goal is to protect our patients from the unexpected. We have to constantly imagine the worst-case scenario so that if, or when, it happens we not only recognize it early, we’re ready for it. What we’re often not good at is protecting ourselves at work. We tend to be so patient focused that we often don’t even think about personal hazards. This article discusses some of the risks we face during airway management of the infectious patient. Read More …

Airway Obstruction Can Occur After Thyroglossal Duct Excision

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Airway obstruction can occur following uneventful thyroglossal duct excision because of removal of the hyoid bone. This article describes reasons why the anatomical change can cause obstruction and discusses a case where such airway obstruction needed treatment in the immediate postoperative period. Read More …

Beware: Your Patient Can Bite That Pilot Tube

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Persistent endotracheal tube leaks may require the need to exchange the endotracheal tube in a critical patient or situation. The differential diagnosis of such leaks is discussed. In addition, a case regarding a patient biting a pinhole in the pilot tube of their endotracheal tube is presented. Read More …

Using Straight Laryngoscopy Blades

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Intubation by direct laryngoscopy depends on using the laryngoscope blade to give you a clear field of view of the larynx by shifting the tongue and other pharyngeal structures out of the way. As you might imagine, the patient’s anatomy, pathology, or position can sometimes make this visualization difficult. Laryngoscopy blades come in different shapes to help manage these various situations. Read More …