title: Removal of obstructing T-tube and stabilization of the airway.
abstract: Although they are extremely effective in maintaining tracheal and subglottic patency, T-tubes themselves can result in airway obstruction from plugging. Many practitioners educate patients on placing a small (5.0) endotracheal tube (ETT) through the tracheal limb of the T-tube if they develop airway obstruction. Unfortunately, this can be a difficult task to complete during acute airway obstruction. In this article, we describe a simple set of steps for rapid relief of airway obstruction and stabilization of the airway in the event of T-tube obstruction. This method requires removal of the T-tube with a Kelly clamp and stabilization of the airway with a tracheostomy tube. Although it is simple, we hope that this technique will prevent morbidity and mortality from acute airway obstructions related to T-tubes.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232-8605, USA. sanjay.m.athavale@vanderbilt.edu
authors.forename: Sanjay M
authors.initials: SM
authors.lastname: Athavale
authors.forename: Jennifer
authors.initials: J
authors.lastname: Dang
authors.forename: Sanjeet
authors.initials: S
authors.lastname: Rangarajan
authors.forename: Gaelyn
authors.initials: G
authors.lastname: Garrett
mesh_terms: D000402:Airway Obstruction / Q000628:therapy*; D020878:Device Removal / Q000379:methods*; D004868:Equipment Failure; D006801:Humans; D011183:Postoperative Complications / Q000628:therapy*; D014135:Tracheal Stenosis / Q000628:therapy*; D014139:Tracheostomy / Q000295:instrumentation*