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Department of Anesthesia, Stanford University, California
Address correspondence and reprint requests to Vladimir Nekhendzy, MD, Stanford University Medical Center, Department of Anesthesia, Route 2, 300 Pasteur Dr., Stanford, CA 94305-5640. Address e-mail to nek{at}stanford.edu
We describe a technique by which a gum elastic bougie (GEB) is used to facilitate an anticipated difficult endotracheal intubation in a patient undergoing rigid bronchoscopy. After placing the GEB through the lumen of the rigid bronchoscope, the GEB-suction catheter assembly was used to safely withdraw the bronchoscope in a manner mimicking the withdrawal of an intubating laryngeal mask airway (LMA) over the endotracheal tube using a stabilizer rod. The rationale for management and potential advantages of this approach versus use of an airway exchange catheter (including increased stability of an intubation guide) are discussed.
IMPLICATIONS: We describe a technique of using a gum elastic bougie to facilitate an endotracheal intubation in a patient undergoing rigid bronchoscopy, which can be useful in a variety of clinical situations when the rigid bronchoscope is used in patients with abnormal airway.
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M. El-Orbany, M. R. Salem, V. Nekhendzy, and P. Simmonds The Eschmann Tracheal Tube Introducer Is Not an Airway Exchange Device * Response Anesth. Analg., October 1, 2004; 99(4): 1269 - 1270. [Full Text] [PDF] |
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