Cite this post as:
Scott Weingart, MD FCCM. EMCrit Wee – Converting a Laryngeal Airway to an Endotracheal Tube while Maintaining Ventilation. EMCrit Blog. Published on December 10, 2015. Accessed on May 10th 2024. Available at [https://emcrit.org/emcrit/convert-lma/ ].
Financial Disclosures:
Dr. Scott Weingart, Course Director, reports no relevant financial relationships with ineligible companies.
This episode’s speaker(s), (listed above), report no relevant financial relationships with ineligible companies.
CME Review
Original Release: December 10, 2015
Date of Most Recent Review: Jan 1, 2022
Termination Date: Jan 1, 2025
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Good video. One thing that might make things easier is to use a generous amount of silicone spray (or silicone jelly) on the surface of your bronchoscope. We find that the silicone spray allows the plastic to slide like butter along the bronchoscope.
Careful not to let the spray end up on the floor! it’ll be an ice skating rink.
big debate in the anesthesia world as to what is truly safe fro bronch lubrication. ?s as to whether silicone is actually safe or not.
I can’t vouch for its safety but I can definitely vouch for its effectiveness. When I have an unsecured airway I’ll err on the side of doing everything to optimize my success – in exchange for the tiny possibility of causing harm in the future.
In the pre-hospital setting we use EGDs mainly in cardiac arrests, then intubate after we have ROSC. We currently use the I-Gel and my issue is that we can only get a 6.0ETT through the I-Gel. If the patient is likely to be a easy intubation using DL or VL, I will generally opt to pull the tube and risk 10-15 seconds off the bag to get a tube that will deliver the volumes I think the patient needs. If they look to be a difficult intubation then I might consider intubating through the I-Gel but most likely will leave… Read more »
Say you don’t have a bronch/ambuscope to make this transfer. Thoughts on using a bougie instead? Or even blind ETT insertion?