Pei-Jen Kuoa, b, Yu-Chi Lina, b, Ming-Hwang Shyra, b
a Department of Anesthesiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
b Department of Anesthesiology, Tzu Chi University, Hualien, Taiwan
Abstract
The Trachway video intubating (TVI) stylet has been widely investigated and is used for both normal and difficult intubations. Practitioners may use the longer 420 mm shaft stylet for orotracheal intubation. However, an endotracheal tube stop is needed to prevent displacement of the endotracheal tube during stylet advancement in the oral cavity. The original tube stop, which can be purchased from the manufacturer, is small and easy to lose. We designed a device derived from a 95 mm long segment of surgical drain pipe that is able to replace the original endotracheal tube stop and then explored the feasibility of using it on an airway management trainer manikin. A conventional #7.0 endotracheal tube was preloaded and its fixation tested by gentle upward and downward sliding. The TVI stylet was inserted via the oral opening. A chin lift (one-hand) or jaw thrust (two-hand) maneuver facilitated recognition of the laryngeal anatomy and locating the epiglottis. The TVI stylet was then further advanced through the glottis opening, in order to complete the tracheal intubation; this was done without difficulty. We conclude that the use of a 95 mm long surgical suction pipe is able to prevent displacement of an endotracheal tube during TVI advancement and this device can be used successfully to replace the original tube stop. This facilitates orotracheal intubation with a long stylet.
Keywords
Difficult intubation; Intubating stylet; Video laryngoscope
