Advanced Intubation Adjuncts
Endotracheal Tube
One alternative advanced airway is the endotracheal (ET) tube. This tube comes through the nose or mouth. This is the hardest airway to put in place, but it is also the most secure. Only experienced providers are equipped to handle ET intubation. You need to use a laryngoscope with this technique. Fiber optic laryngoscopes are becoming more popular because they have a video screen and thus improve success.
Laryngeal Mask Airway
Another alternative advanced airway is the laryngeal mask airway (LMA), which provides adequate ventilation. Using the LMA instead of an esophageal-tracheal tube in maintaining airway management during cardiac arrest is acceptable. An experienced ACLS provider can quickly secure placement of an LMA device.
Laryngeal Tube
The laryngeal tube offers similar advantages to the esophageal-trachael tube, but it is also less complicated and more compact. One large balloon inflates with this tube, allowing you to insert it blindly.
Esophageal-Tracheal Tube
Also known as a combitube, another alternative to ET intubation is the advanced airway of the esophageal-tracheal tube. Like the ET tube, a useful amount of ventilation is allowed by the esophageal-tracheal tube. There are two different balloons in the combitube that are inflated, along with two separate ports. It is the provider’s responsibility to tell which port must be used to ventilate, to ensure enough oxygenation.
- During CPR, the chest compression to ventilation rate for adults is 30:2.
- Give one breath every 6 seconds with continuous chest compressions; do not stop chest compressions for breaths if an advanced airway has been administered.