Combi-Tube vs ET tube?

[c-spine]

What's the difference in a Combi-tube and an ET tube? Don't they both go to the same place? (Yes, I know - I should know this) :blush:

 

[DT4EMS]

What's the difference in a Combi-tube and an ET tube? Don't they both go to the same place? (Yes, I know - I should know this) :blush:

The ET (EndoTracheal) is supposed to go into the trachea with direct visualization. I say supposd to because the number 1 patient care realted issue in EMS is airway.

The Combi-Tube is a blind isnertion type device. The way it is designed to work is; more likely than not a tube inserted into a patients mouth will go into the esophogus. The Combi-Tube has the ability to ventilate a patient indirectly( by bloacking off the esophogus) and directly into the trachea. An ETT ventilates directly into the trachea.

Kinda short response I know, but it is much easier to "show you" how it works.

 

[c-spine]

-thinks for a minute-

Ok, it makes sense. I knew ET meant endotracheal, but I couldn't figure out the difference... hehe... long day. x.x

 

[Ridryder911]

Basically add this.... ETT gold standard, nothing better. Combi-tube, alternative airway when you can not get someone intubated....

R/r 911

 

[fm_emt]

... and, in some areas, an EMT-B can intubate with a combitube.

Although I'm not entirely sure if it's *only* a combitube or if they actually cover the ET tube intubation as well.

Our county is not one of those counties, but I believe that some counties up in far northern California allow it.

 

[joemt]

I don't think it's called "intubation" when you place a Combi-Tube.. but, honestly I don't know.... I don't want my students thinking that they are "intubating" when they insert this or any other BLS device.

 

[fm_emt]

I don't think it's called "intubation" when you place a Combi-Tube.. but, honestly I don't know.... I don't want my students thinking that they are "intubating" when they insert this or any other BLS device.

I was using the literal definition which is "To insert a tube into a hollow organ or body passage."

I think that a combitube would count, as it's a tube, and the esophagus is a hollow body passage. Once I go through the class, I'm sure I'll have a better idea. I better, anyway!

I'll shut up now. ;-)

 

[Wingnut]

Do you all still use the "regular" ET tubes? They switched us to King tubes several months ago.

 

[emtbuff]

We had an inservice at the hospital covering Airways last week. It was the first time I had seen a king LT. Which looked alot like a combitube. Just smaller, and used only 1 syringe. I know they still use ET tubes. Now a question for others as the flight nurse giving the inservice said not to use the LMA as a doctor that does Locum here decided that is what he wanted and so of course we got them. Oh and he wanted them for Code situations. We were told to not use them as they don't protect the airway addequately enough like the combi, ET, or King LT would. We were told that the LMA's worked well in a surgical setting but other then that to not use them.

So I guess with all this rambling I'm asking are you allowed to use LMA's or not??

I think the nursing department decided that we would not be grabing for that one as a primary airway.

 

[joemt]

Our flight Medics and Nurses here LOVE LMA's

 

[c-spine]

Lma.... ???

 

[emtbuff]

LMA--laryngeal Mask Airway

Joemt- do they have a problem with aspiration?? I think that was the main concern when we were talking about them here.

 

[joemt]

Honestly, I don't know.... I'll have to ask our Flight Team.... I'll let you know.

 

[Ridryder911]

LMA's have proven to be very unstable on the field arena. Yes, they are easy to insert, and use the problem is the stability... they pop out. Many have quit using them because of this..

King airways are a modified combi-tube..

R/r 911

 

[Ridryder911]

For those that want to see what a LMA looks like here video I posted. This is a conscious intubation with one, and a whistler attachment.. (* Please do not attempt this at home, trained professional

http://www.youtube.com/watch?v=HXjPdNSL96c&search=intubation

 

[gradygirl]

This might be veering off topic a little bit, but is it possible for someone to self-intubate? According to local EMS lore, a good friend of mine got pissed off at a drunk pt. and made the guy intubate himself. :huh:

 

[Ridryder911]

Need to make a bet on that one.. Although I have seen many people without a "gag" reflex ( no other comments) it is very hard to intubate a non-responsive versus an awake. One needs to be very careful as well not to cause laryngospasm with the touching of chords, or epiglottis.

For as self intubating... total B.S. Someone shooting of remarks from the wrong end, don't be gullible.....


R/r 911

 

[c-spine]

How that woman didn't move... I would have been coughing and gagging and swinging at whoever was trying to put that down my throat!!

 

[gradygirl]

How that woman didn't move... I would have been coughing and gagging and swinging at whoever was trying to put that down my throat!!

No kidding. And the whistling sound the tube made would have freaked me out.

 

[c-spine]

LOL... yeah... I would have self un-intubated really quickly, doctors orders or no.