Interchangeable oral-nasal Endotracheal Tube

This novel innovation is the world’s first oral/ nasal interchangeable endotracheal tube. It offers a method to change between an oral endotracheal tube to a nasal endotracheal tube (and vice versa) without reintubation, while ventilation is maintained.

This method is ideal for use in maxillofacial surgery, where both oral and nasal intubation may be required. It is suitable for initial intubation of trauma patients in the emergency department over a bougie or with a stylet, where nasal intubation may be later required for maxillofacial surgery or patient transport. It provides a secure endotracheal tube/ airway for ventilation of children in ICU. It is also useful in managing a difficulty airway when intubating over a bougie or fibre optic scope.

Benefits of the interchangeable oral-nasal endotracheal tube include:

After initial orotracheal intubation continued intubation and ventilation allows for all subsequent steps to be performed in a safe, controlled manner.

Interchangeable oral/nasal endotracheal tube negates the need for extubation and reintubation.

The risk of bleeding and secretions from manipulation of an endotracheal tube through the nasopharynx making intubation difficult is removed.

Atraumatic nasal intubation with soft, flexible and blunt introducer attached to flexible reinforced airway tubing has been shown to reduce the risks associated with nasal intubation.

Flexible reinforced airway tubing allows intubation through the safer lower nasal pathway.

A safe method of nasotracheal intubation for those practitioners not skilled in the art of standard nasotracheal intubation.

No need for airway exchange catheters.

All Genesis airway endotracheal tubes have posterior facing bevels shown to be safer when passed through the nasopharynx and to provide a greater initial success rate of intubation when railroaded over a bougie or fibreoptic scope.

All Genesis airway endotracheal tubes have a curved atraumatic bevelled tip preventing hang up on laryngeal structures when used with a bougie or fibre optic scope.

All Genesis airway endotracheal tubes have high volume low pressure cuffs to seal the airway without trauma.The reinforced endotracheal tubes are manufactured with soft, smooth PVC with a non stick finish allowing easy railroading over a bougie or scope.

Contraindications:

Suspected base of skull fractures

Bleeding diathesis

Our interchangeable oral-nasal endotracheal tube is presented as a pack containing:

Flexible reinforced endotracheal tube with a posterior facing bevel, modified cuff inflation line insertion and a removable 15 mm ISO connector.

Flexible reinforced airway tubing having a fixed 15 mm ISO connector and a connector to mate to an Introducer.

malleable stylet.

Method of Use

ORAL TO NASAL ENDOTRACHEAL TUBE

A reinforced endotracheal tube with a posterior facing bevel is placed in the trachea in the preferred manner of the practitioner. It is connected to the anaesthetic circuit to maintain anaesthesia and ventilation. The cuff inflation balloon and line may be stored in the mouth.

The reinforced airway tubing having the same internal and external diameters as that of the endotracheal tube with a standard 15mm connector at the proximal end and a male connector at the distal end is connected to a curved, tapered, blunt introducer.

The appropriate nostril for intubation is selected and the introducer is passed through the nasopharynx. When introducer is visible in the oropharynx it is grasped with Magill’s forceps and delivered through the mouth. Once the distal 5cm of the airway tubing is out of the mouth the introducer is removed from the airway tubing.

The anaesthetic circuit is then removed from the endotracheal tube and connected to the proximal airway tubing.

The 15mm connector is removed from the reinforced endotracheal tube and it is connected to the distal airway tubing allowing continuous ventilation. The proximal reinforced endotracheal tube is stabilized in the oropharynx and the redundant loop of distal endotracheal tube and proximal airway tubing is reduced by gentle traction distal to the nares. Once reduced the distal endotracheal tube now distal to the nares is disconnected from the airway tubing the 15mm connector is replaced and it is connected to the anaesthetic circuit.

For removal the nasal tube may be reconverted to an oral tube or the cuff inflation balloon and line may be cut off next to the endotracheal tube and the tube removed via the nasopharynx.

NASAL TO ORAL ENDOTRACHEAL TUBE

The anaesthetic circuit is removed from the endotracheal tube and connected to the proximal airway tubing.

The 15mm connector is removed from the endotracheal tube and the end of the endotracheal tube is connected to the distal airway tubing allowing continued ventilation.

The proximal end of the endotracheal tube is stabilized in the oropharynx and a redundant loop of distal endotracheal tube and proximal airway tubing is delivered through the mouth by gently pushing the tube distal to the nares.

The endotracheal tube and airway tubing are disconnected and a 15mm connector is reinserted into the endotracheal tube. This is connected to the anaesthetic circuit for maintaining ventilation and anaesthesia.

The introducer is reconnected to the airway tubing to cover the male connection of the airway tubing and prevent trauma as it is withdrawn through the nose.

SIZES – INTERNAL DIAMETER OF TUBE:

8.5mm
8.0mm
7.5mm
7.0mm
6.5mm
6.0mm
5.5mm
5.0mm