Oral Screw

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They are no longer used. When I first started out they were as popular as an oral-pharyngeal airway (also bite blocks). The problem is they will pop out teeth and tear muscles.

Fortunately, we have became more educated and realize to stop the activity to be able to open the mouth per pharmacological agents and or treat the cause.

R/r 911
 
marineman said:
I don't think we carry different tubes for nasal intubation. I'm not positive but I'd assume we are allowed to do it. In class we always used a standard ETT for nasal.
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Check out:
http://www.youtube.com/watch?v=HXjPdNSL96c
It was posted by someone on this forum a year+ ago. In it you'll see the whistler (BAAM).

For your service which is probably like mine, we don't have much more than a scope and colormetric, let alone capnography or BAAM. Did they show you the trick to roll up the ETT? If not:

Roll the ETT into a complete ring. Try to keep the shape as you advance it down the nare (keep in mind you will have to aim slightly toward midline), once you guesstimate that it's getting deep enough and in the general area of the cords, start to listen for respirations/coughing through the tube. Ya should be able to freely keep advancing (and continuing to hear sounds) until ya get deep enough with the tube, inflate and hopefully you've got some good anatomy and otherwise luck +finesse on your side. Just an option when ya don't have the equipment or other alternatives.
 
The department I'm doing my rides with has surgical cric in their protocols so they might jump straight to that if they can't do a standard ETT but I'll have to look into it. Thanks for the pointers either way.
 
I have performed hundreds of nasal intubations and never have opened their mouth. Why nasally intubate if I can do it orally?

Manipulation of the head and on a breathing patient feeling the "pop" as it goes through the glottic opening. An old trick I have learned in ambient noise areas is to take the bell off a cheap stethoscope and place the tube slightly into the ETT. You will hear the breathing much more clear and can introduce the tube upon inspiration. * Sorry Vent I know its not sterile..

The other technique is the digital intubation technique which I have done a few times but that is a totally different story.. if you are able to check out the Old archives, I wrote an article on special techniques of intubation many decades ago for JEMS.

R/r 911
 
I was expecting something very different when I clicked on this link.
 
Ridryder911 said:
The other technique is the digital intubation technique which I have done a few times but that is a totally different story.. if you are able to check out the Old archives, I wrote an article on special techniques of intubation many decades ago for JEMS.

R/r 911
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Digital is my specialty in class anyway, doesn't seem like something I'd ever want to try on a real patient. God has gifted me with very long very skinny fingers that work very well for digital intubation.
 
God has gifted me with very long very skinny fingers that work very well for digital intubation.
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I never got one on a dummy, and I'll probably never get an oral intubation on a live person either. God has cursed me with short, fat fingers that could not reach far enough :]
 
VentMedic said:
The Endotrol is expensive at about $11.50/tube vs $2.00 per regular ETT.

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Yes, They do cost more, but do increase intubations on the first try. You may only do one nasal a month, so the cost is not to bad.

I use regular ETT for nasal too. It is just a little easier with the nasal tube.
 
Wow, duh. Change oral to digital in my last post.
 
Yea, trigger tube does not = nasal tube. No need for a BAAM, but get in where you fit in. If it helps, use it. Used to BNTI A LOT (notice "a lot" is not one word), CPAP has changed that practice a bit. Speaking of changing practice? That screw is dope!!! I have not seen those in forever. I remember way way back my gym teacher even had one on his keychain. It was OK to hit kids with a plywood board then too though. It was a beautiful piece of wood. What kind of sick f**k puts that kind of work into a board for hitting kids?

Egg
 
Ridryder911 said:
They are no longer used. When I first started out they were as popular as an oral-pharyngeal airway (also bite blocks). The problem is they will pop out teeth and tear muscles.

Fortunately, we have became more educated and realize to stop the activity to be able to open the mouth per pharmacological agents and or treat the cause.

R/r 911
Click to expand...
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