The modified nasal trumpet maneuver.
The last decade has witnessed a proliferation of devices or methods that facilitate intubation in difficult circumstances, maintain ventilation, or which do both. These all require properly functioning and specially designed apparatus, the use of which requires variable degrees of expertise. This technical communication describes the author's experience with a simple technique that uses virtually universally available materials--a nasal trumpet (airway) and an endotracheal tube (ETT) connector--to rescue patients in the cannot-ventilate/cannot-intubate scenario. The methodology is straightforward, ventilation is usually immediate, stomach contents can be evacuated while ventilation proceeds, and it does not require mouth opening. Moreover, while ventilation and oxygenation is continuing, a fiber-optic intubation can proceed without interference.


CONCLUSIONS
A simple technique is proposed that can be used to rescue patients who are in a condition of cannot intubate/cannot ventilate. The described maneuver may save patients from requiring a surgical airway.
Beattie
Charles
C
Department of Anesthesiology, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee 37232-4125, USA. chas.beattie@mcmail.vanderbilt.edu.
D000328:Adult; D000402:Airway Obstruction; D004630:Emergencies; D006801:Humans; D007440:Intubation / Q000295:instrumentation*; D009666:Nose; D011175:Positive-Pressure Respiration; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods