effects of fluid in the lungs with ROA ETT

Lifeguards For Life

Lifeguards For Life

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Earlier, some of us were discussing the effectiveness of administering drugs through an ET tube, when i had asked "if the patient had fluid in their lungs, wouldn't the fluid partially or maybe fully obstruct the systemic absorption of the drug administered through the ET tube?" A lot of different etiologies produce fluid in the lungs. So how (if so) would fluid in the lungs effect the successful systemic absorption?
-alot of people saiod this question was right down vent's ally...
 
Medication absorption through the pulmonary route is very inefficient as it is. Add pulmonary edema on top of it and you now have an even greater diffusion distance for the medication to have to try and traverse through to reach the pulmonary vasculature.

Most of the time if the patient has a fair amount of fluid in the lungs the meds end up coming back up the ET tube and dont get absorbed at all.
 
They recently took this route out of our protocols. After a review of the records, there were no real positive outcomes. I can't say for sure what research backed this but... From what I was taught and what I've seen; There were no positive outcomes or changes.
 
cm4short said:
They recently took this route out of our protocols. After a review of the records, there were no real positive outcomes. I can't say for sure what research backed this but... From what I was taught and what I've seen; There were no positive outcomes or changes.
Click to expand...

I have heard that this is being removed from many SOP/SOG's across the nation
 
With the increasing availability of adult IO use, there aren't too many times ET meds need to be given.
 
Prior to the more widespread use of adult IO, I considered (and actually still do) putting meds down the tube as a last-ditch option for getting meds onboard. If I have IO available, I'd much rather use that than attempt medicating via ETT. No IO available and I can't get a line... then meds will go down the tube as a last resort.

As far as effectiveness of those meds goes, in a patient who already has fluid in the lungs... I think ResTech pretty much nailed it.
 
Lifeguards For Life said:
Earlier, some of us were discussing the effectiveness of administering drugs through an ET tube, when i had asked "if the patient had fluid in their lungs, wouldn't the fluid partially or maybe fully obstruct the systemic absorption of the drug administered through the ET tube?" A lot of different etiologies produce fluid in the lungs. So how (if so) would fluid in the lungs effect the successful systemic absorption?
-alot of people saiod this question was right down vent's ally...
Click to expand...

Yes it would.
 
I'm surprised this is still an option for people. This was taken out of our protocols prior to me getting my medic card. Our medical director would thump us if we ever put meds down the tube.
 
We didn't remove it completely from our protocols but it is highly discouraged. Really, since we brough EZ-IO on board there really is no excuse to use ETT as a route for drug administration but we do still keep it as an absolute last ditch effort.
 
In South Africa, not removed but also a last line.

"Tracheal drug administration is not recommended as a first
line option - it is a last resort route of administration, and
should only be used if intravenous or intraosseous routes
are unavailable."
 
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