Journal of Anesthesiology & Clinical Science

Journal of Anesthesiology & Clinical Science

ISSN 2049-9752
Case report

Fiberoptic, wire-guided king laryngeal tube exchange in trauma patients: a case series

Richard E. Galgon1†*, Aaron M. Joffe2†, Karl Willmann1† and George A. Arndt1†

*Correspondence: Richard E. Galgon galgon@wisc.edu

These authors contributed equally to this work.

1. Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.


Author Affiliations

2. Department of Anesthesiology and Pain Medicine, University of Washington-Harborview Medical Center, Seattle, WA, USA.

Abstract

The laryngeal tube is increasingly being used for prehospital airway rescue. However, its exchange for an endotracheal tube can be challenging and risky. No best technique to achieve this end is yet accepted. We report three trauma cases where a fiberoptic, wire-guided, laryngeal tube-to-endotracheal tube exchange using the Arndt Exchange Catheter Set was performed. Three patients with multiple traumatic injuries presented to the emergency department with a laryngeal tube, with or without a gastric port, in place. All were in cervical stabilization collars. One had blood and gastric contents filling the ventilation tube and gastric port, respectively. One was undergoing cardiopulmonary resuscitation. In all cases, a fiberoptic bronchoscope and an Arndt Exchange Catheter Set were used to successfully exchange the laryngeal tube for an endotracheal tube without loss of airway control. In each case, the technique allowed continuous ventilation and oxygenation of the patient nearly throughout the entire exchange process. In conclusion, fiberoptic, wire-guided airway management using the Arndt Exchange Catheter Set can be successfully used to exchange the laryngeal tube for an endotracheal tube in trauma patients and provides a technique that maintains relative airway control throughout the entire exchange procedure, while providing nearly continuous ventilation and oxygenation.

Key words: laryngeal tube, wire-guided, exchange

ISSN 2049-9752
Volume 1
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