Combi-Tube vs ET tube?

[Ridryder911]

If you noticed that they lidocaine injected in the neck.... it was a neurosurgery so the patient had remain awake...

R/r 911

 

[gradygirl]

well, self intubation may be total b.s., but self extubation is a very possible situation, though i'm sure very regrettable after the fact.

 

[Ridryder911]

That is why protocols should include restraints and additional sedation and paralytics for patients awakening.
R/r 911

 

[KEVD18]

while useful as a last ditch effort, as a secure airway the combitube doesnt cut it. the probability of you sucessfully intubating the trachea is very small, so you'll be in the esophagus by default. esophageal obturation is not a secure airway

if your a basic who dropped a c-t prior to the arrival of the als crew, you have just changed the whole dynamic if the call. medics, at least not the medics i work with, wont push drugs down a c-t. and they cant/wont pull your c-t to place an e-t due to the high probability of airway trauma preventing the ett placement. and they wont be happy be4cause they dont have a 100% secure and patent airway.

sont even get me started on the lma

 

[RALS504]

Combitubes have thier place in EMS.
Pros
-all EMTs can place one
-great rescue airway when ET tube can not be placed
-effective

Cons
-can't push med through unless you have tracheal placement
-it is supose to only be in place 8 hours or less
-it is some what of a secured airway from emesis, but not from
-tracheal/epiglotis swelling

If you are an EMT and you do not have intubation privilages placing a combitube on a pt is probably appropriate. I am not advocating dropping a combitube as your ALS unit is pulling in the driveway of the scene. But if you are intercepting ALS and you are five minutes away or more then place your combi tube.

 

[brentoli]

while useful as a last ditch effort, as a secure airway the combitube doesnt cut it. the probability of you sucessfully intubating the trachea is very small, so you'll be in the esophagus by default. esophageal obturation is not a secure airway

if your a basic who dropped a c-t prior to the arrival of the als crew, you have just changed the whole dynamic if the call. medics, at least not the medics i work with, wont push drugs down a c-t. and they cant/wont pull your c-t to place an e-t due to the high probability of airway trauma preventing the ett placement. and they wont be happy be4cause they dont have a 100% secure and patent airway.

So you are saying that if I have a code, and ample manpower, not to drop a combi when my ALS truck is still miles away?

 

[c-spine]

I don't think that's what was meant... if it's going to save the patient's life... do it. If your truck is a few miles out and your patient is coding... go to combi tube.