Advanced airway adjuncts

Advanced Airway Adjuncts

Airway Adjunct	Eamples	Pros	Cons
Endotracheal tube introducer	Gum elastic bougie	Higher first pass success when used with direct laryngscope vs. styletted ET tube regardless of whether difficult airway was expected or not
Lighted optical stylets		High success rate - especially good for trauma, c-spine precautions *Use for both reg and nasotrach Lower complication rate	Limited by fogging, secretion, recognition of anatomy, cost, and rare provider experience
Supraglottic airway	LMA
Esophogeal obturator	Combitube	Good for nurses and paramedics with limited intubation skill Indicated if difficult airway predicted: cannot see glottis with laryngoscope Reduced risk for aspiration compared to face mask or LMA *Can maintain spinal immobilization	Large size predisposes to esophogeal dilatation and laceration as a complication
Percutaneous transtracheal ventilation		Prefered over crithyrotomy in children up to age 10-12 Oxygenates well *Can use for 30-45 min	Can retain CO2 *May cause pneumothorax or barotrauma

See Also

Airway Pages

• Pre-intubation
  • Predicting the difficult airway
  • Bag valve mask ventilation
    • Oropharyngeal airway
    • Supraglottic airway
  • Apneic oxygenation
    • EBQ:ED Preoxygenation
• Induction
  • Critical care quick reference
  • Rapid sequence intubation
  • Delayed sequence intubation
• Intubation
  • Intubation (peds)
  • Direct laryngoscopy
  • Video Laryngoscopy
  • Bougie
  • The difficult airway
  • Advanced airway adjuncts
    • Supraglottic airway
  • Non-traditional intubation
    • Awake intubation
    • Nasal intubation
    • Blind digital intubation
• Surgical airways
  • Surgical cricothyrotomy
  • Needle cricothyrotomy
  • Pediatric jet ventilation
• Post-intubation
  • Mechanical ventilation (main)
  • Deterioration after intubation (DOPE)