ESOPHAGEAL TRACHEAL COMBI-TUBE


 
An esophageal tracheal combitube consists of a twin-lumen tube with a proximal low-pressure cuff that seals the pharyngeal area, a distal cuff that seals the esophagus (or the trachea), and ports for ventilation in-between.

The pharyngeal lumen and KING LT supraglottic airways have similar function.
It is available in two sizes only.
■ 37F: Small adult/large child
■ 41F: Larger adults
 
INDICATIONS
  • Apneic and unconscious adult with
  • Failed intubation
  • Limited mouth opening
CONTRAINDICATIONS
  • Patient with intact airway reflexes
  • Esophageal disease
  • Caustic ingestion
  • Upper airway obstruction
  • Children ≤4 feet tall
PROCEDURE
 Grab and elevate the tongue and jaw with non- dominant hand...
■ Pass the tube blindly into the pharynx until the marker on the tube is between the patient's teeth.
        - Placement is facilitated by neck flexion.
■ Inflate the pharyngeal balloon with 100 mL of air.
■ Inflate the distal white balloon with 5-15 mL of air.
■ Begin ventilation through the longer (blue) connector.
        - Air entry to lungs → confirms esophageal placement.
        - Air entry into stomach →tracheal placement (rare), in which case confirm with ventilation through shorter (clear) tube.