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Rosann Juska trauma-list@trauma.orgSun, 3 Mar 2002 14:11:16 -0800
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I love the Combi tube!!! I often use it instead of an oral or nasal, if =
the situation is right. You can not use it for persons under 5 foot, has =
a gag reflex, a person who had ingested a corrosive substance of someone =
with an esophageal disease such as Cancer, or severe upper airway =
bleeding b/c it will pass directly into the lungs once the cuff has =
closed off the esophagus. It can be inserted "blindly" which avoids =
improper placement. I am not sure if this answered your question, but if =
not I can try again!
=B8..=B7 =B4=A8=A8)) -:=A6:-
=B8.=B7=B4 .=B7=B4=A8=A8))
((=B8=B8.=B7=B4 ..=B7=B4 -:=A6:-=20
-:=A6:- ((=B8=B8.=B7=B4* =20
Rosann Juska
EMT-P/ER Tech/IC
"We all take different paths in life, but no matter
where we go, we take a little of each other everywhere."
--- Tim McGraw
"The fate of the wounded rest
in the hands of the one that
applies the first dressing."
-- Nicholas Senn, 1896
----- Original Message -----=20
From: Keith D. Lamb=20
To: trauma-list@trauma.org ; Respiratory Care Professionals World =
Forum ; ccm-l@list.pitt.edu=20
Sent: Sunday, March 03, 2002 7:58 AM
Subject: (no subject)
How often are folks intubating with double lumen endotracheal tubes =
and for what indications? I don't meant intra-op for thoracic =
surgery...but pre-op...or post-op...for specific injury/pathology and to =
facilitate independent lung ventilation.=20
=20
For what injury/pathology are you seeing this performed most often? =
Example parenchymal injury/pathology or bronchus injury.....fistula etc. =
=20
When your patient IS intubated in this fashion and each lung is being =
ventilated independently.....what kind of strategy do you employ =
regarding ventilator modes. Do you synchronize or not. Do you attempt to =
use just a little bit of CPAP with the injured side...or some other =
strategy. Do you conventionally ventilate the healthy lung and "jet" or =
"oscillate" the injured lung? Does tracheal gas insufflation have a role =
in this setting? Any thoughts?
=20
keith
=20
Keith D. Lamb RCP, RRT
Christiana Care Hospital
Newark, Delaware
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<STYLE></STYLE>
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<BODY bgColor=3D#ffffff>
<DIV><FONT color=3D#008080 face=3D"Goudy Old Style">I love the Combi =
tube!!! I often=20
use it instead of an oral or nasal, if the situation is right. You can =
not use=20
it for persons under 5 foot, has a gag reflex, a person who had ingested =
a=20
corrosive substance of someone with an esophageal disease such as =
Cancer, or=20
severe upper airway bleeding b/c it will pass directly into the lungs =
once the=20
cuff has closed off the esophagus. It can be inserted "blindly" which =
avoids=20
improper placement. I am not sure if this answered your question, but if =
not I=20
can try again!</FONT></DIV>
<DIV><BR>=B8..=B7 =B4=A8=A8)) -:=A6:-<BR> =
=B8.=B7=B4=20
.=B7=B4=A8=A8))<BR> ((=B8=B8.=B7=B4 =
..=B7=B4 -:=A6:- <BR> =20
-:=A6:- ((=B8=B8.=B7=B4* =20
<BR> &nb=
sp; =20
Rosann Juska</DIV>
<DIV> &n=
bsp; =20
EMT-P/ER Tech/IC<BR>"We all take different paths in life, but no=20
matter<BR> where we go, we take a little of each other =
everywhere."<BR>---=20
Tim McGraw</DIV>
<DIV> </DIV>
<DIV>"The fate of the wounded rest<BR>in the hands of the one =
that<BR>applies=20
the first dressing."<BR>-- Nicholas Senn, 1896<BR></DIV>
<BLOCKQUOTE=20
style=3D"BORDER-LEFT: #008080 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: =
0px; PADDING-LEFT: 5px; PADDING-RIGHT: 0px">
<DIV style=3D"FONT: 10pt arial">----- Original Message ----- </DIV>
<DIV=20
style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: =
black"><B>From:</B>=20
<A href=3D"mailto:kdlamb@prodigy.net" title=3Dkdlamb@prodigy.net>Keith =
D. Lamb</A>=20
</DIV>
<DIV style=3D"FONT: 10pt arial"><B>To:</B> <A=20
href=3D"mailto:trauma-list@trauma.org"=20
title=3Dtrauma-list@trauma.org>trauma-list@trauma.org</A> ; <A=20
href=3D"mailto:RC_WORLD@LISTSERV.IUPUI.EDU"=20
title=3DRC_WORLD@LISTSERV.IUPUI.EDU>Respiratory Care Professionals =
World=20
Forum</A> ; <A href=3D"mailto:ccm-l@list.pitt.edu"=20
title=3Dccm-l@list.pitt.edu>ccm-l@list.pitt.edu</A> </DIV>
<DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Sunday, March 03, 2002 =
7:58=20
AM</DIV>
<DIV style=3D"FONT: 10pt arial"><B>Subject:</B> (no subject)</DIV>
<DIV><BR></DIV>
<DIV><FONT face=3DArial size=3D2>How often are folks intubating with =
double lumen=20
endotracheal tubes and for what indications? I don't meant intra-op =
for=20
thoracic surgery...but pre-op...or post-op...for specific =
injury/pathology and=20
to facilitate independent lung ventilation. </FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV><FONT face=3DArial size=3D2>For what injury/pathology are you =
seeing this=20
performed most often? Example parenchymal injury/pathology or bronchus =
injury.....fistula etc. </FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV><FONT face=3DArial size=3D2>When your patient IS intubated in =
this fashion=20
and each lung is being ventilated independently.....what kind of =
strategy do=20
you employ regarding ventilator modes. Do you synchronize or not. Do =
you=20
attempt to use just a little bit of CPAP with the injured side...or =
some other=20
strategy. Do you conventionally ventilate the healthy lung and "jet" =
or=20
"oscillate" the injured lung? Does tracheal gas insufflation =
have a=20
role in this setting? Any thoughts?</FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV><FONT face=3DArial size=3D2>keith</FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT> </DIV>
<DIV><FONT face=3DArial size=3D2>Keith D. Lamb RCP, RRT<BR>Christiana =
Care=20
Hospital<BR>Newark, Delaware</FONT></DIV></BLOCKQUOTE></BODY></HTML>
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