Use of a Beck Airway Airflow Monitor and controllable-tip endotracheal tube in two cases of nonlaryngoscopic oral intubation.
Alternative techniques and equipment for intubation may be particularly useful in settings such as air-medical transport, prehospital on-scene care, mass casualty incidents, or incidents in which there may be a lack of medications or equipment. Once traditional techniques of endotracheal intubation and tube verification have been mastered, emergency medicine residents and other intubators should be encouraged to learn alternative techniques, such as these, that may be of use in some special situations, even within the ED. Neither of these two techniques of BAAM-assisted blind oral intubation can be considered essential, nor should it be contended that these techniques supplant learning of more conventional methods of endotracheal intubation and tube placement verification. However, particularly in the setting of residency training, multiple methods of endotracheal intubation should be taught in order to allow the clinician alternative methods if unable to intubate by traditional means in a particular setting. Use of a BAAM to assist in blind oral intubation of a spontaneously breathing patient may allow for oral intubation of awake patients without the additional use of paralytic medications. Use of the BAAM with a digital technique during external cardiac massage may facilitate intubation by the digital technique and help to verify endotracheal tube position. These two additional uses for the BAAM should be noted and these two additional methods of airway control be recognized as backup methodologies in the armamentarium for situations in which they may be needed.
Cook
R T
RT
Department of Emergency Medicine, Medical College of Pennsylvania, Philadelphia.
Stene
J K
JK
Marcolina
B
B
D000368:Aged; D005260:Female; D006323:Heart Arrest / Q000628:therapy; D006333:Heart Failure / Q000150:complications / Q000628:therapy*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D008297:Male; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*