vomiting during intubation? tube the esophagus

13 Apr

quick handy tip from this EMCRIT podcast for a vomit (or blood) laden oropharynx during intubation:jan_08_jems_intubation101

blindly (since you can’t see anything) insert an ETT; if it happens to be tracheal, great.

more likely, it’ll be in the (esopha)gUs.  LEAVE IT THERE.  you can intubate around it shortly, and you now have a landmark to intubate over. 

now here’s the tip: INFLATE the cuff on the esophageal ETT.  Also remember to tilt the now vomit-spewing ETT to the side, but this is now an outlet for the blood/vomit that won’t obscure your DL view

now, suction, and intubate the trachea.

 

Easy concept, handy tip.  Add it to the toolbox.

(check out the podcast for some more tips, but I thought that was the handiest).

 

References: EMCRIT podcast; picture

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