What is esophageal tracheal Combitube?

The esophageal tracheal combitube (ETC) is a supraglottic airway device that functions as an effective alternative to ventilation via mask and tracheal intubation and is therefore a valuable tool in difficult and emergency airway management.

Where is the Combitube placed?

The Combitube is a disposable double-lumen tube with two cuffs and two pilot balloons that is designed for blind insertion. If blind insertion is difficult or unsuccessful, the Combitube may be placed in the upper esophagus under direct vision with the use of a laryngoscope.

Is Combitube definitive airway?

It is not possible to establish a definitive airway through the Combitube. Insertion of the Combitube is a blind technique intended for providers who have not been trained in laryngoscopy. However, a laryngoscope may be used, permitting insertion under direct vision.

What does a Combitube do?

The Combitube—also known as the esophageal tracheal airway or esophageal tracheal double-lumen airway—is a blind insertion airway device (BIAD) used in the pre-hospital and emergency setting. It is designed to provide an airway to facilitate the mechanical ventilation of a patient in respiratory distress.

Is a Combitube an endotracheal tube?

When direct laryngoscopy is attempted and the vocal cords can be visualized, the Combitube should be placed in the trachea and used as a regular endotracheal tube.

Can you suction a Combitube?

A redesigned Combitube has been described by creating an enlarged hole in the pharyngeal lumen that allows fiberoptic access, tracheal suctioning, and tube exchange over a guide wire (8).

Why does a Combitube have two tubes?

When intubating with a traditional endotracheal tube, care must be taken to visually ensure that the tube has been placed in the trachea while the dual-lumen design of the Combitube allows for ventilation to proceed regardless of esophageal or tracheal placement.

Why would you use a Combitube?

The Combitube is a twin lumen device designed for use in emergency situations and difficult airways. It can be inserted without the need for visualization into the oropharynx, and usually enters the esophagus.

What are the contraindications for a Combitube?

Contraindications to use of the esophageal tracheal Combitube use include esophageal obstruction or other abnormality, ingestion of caustic agents, upper airway foreign body or mass, lower airway obstruction, height less than 4 feet, and an intact gag reflex.

Which cuff is inflated first on a Combitube?

Release your hand from the tube before inflating the cuffs. Inflate the cuffs. When using a King laryngeal tube, use the manufacturer’s recommended volume. When using a Combitube®, inflate the distal balloon first using 10 to 15 mL, then inflate the proximal (pharyngeal, blue) balloon using 50 to 85 mL.

Who invented the Combitube?

With the inventor of the Combitube, Dr. Michael Frass!

What is esophageal tracheal fistula?

Tracheoesophageal fistula and esophageal atresia repair is surgery to repair two birth defects in the esophagus and trachea. The esophagus is the tube that carries food from the mouth to the stomach. The trachea (windpipe) is the tube that carries air into and out of the lungs. The defects usually occur together.

What does tracheal intubation mean?

Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs.

What is esophageal constriction?

Benign esophageal stricture describes a narrowing or tightening of the esophagus. The esophagus is the tube that brings food and liquids from your mouth to your stomach. “Benign” means it’s not cancerous.