Skip to main content

Nasal trumpets..the valuable tool




Nasal trumpets


Their contemporary use is commonly limited to the relief of upper-airway obstruction in two circumstances:



1) after extubation of the trachea in a spontaneously breathing patient, or
2) during mask ventilation when an oral airway (and jaw lift) has failed to produce an acceptable airway.

It has not been previously reported that a standard, single-lumen nasopharyngeal airway could be used effectively to deliver positive-pressure ventilation as a rescue device in the cannot-ventilate/cannot-intubate scenario.

Another important use of the nasal trumpet is what is called the modified Nasal trumpets method or the MNT.

In MNT  The materials used consisted of a 30 or 32 French soft nasal airway (trumpet) and a 7.5- or 8-mm ETT connector. The ETT connector was inserted into the flared or proximal end of the nasal airway.
The mating of the ETT connector to the nasal trumpet can occur quickly.Then you use this "Supraglottic"tool to deliver tidal volumes ,but you have to close the next nostril and mouth cavity. see the photo


The MNT has been used in many cases of difficult airway Scenarios and in difficult to ventilate and difficult intubate night mares.it was of big benifits and saved many lives.

Because it is a supraglotticMNT maneuver requires relaxed or open cords. Initial inability to ventilate has been corrected by the administration of a muscle relaxant, but one must be confident that such inability to ventilate is, in fact, a supraglottic problem. The technique is not suitable for a patient with occluded or compressed nasal passages.


Gastric distention, regurgitation, or aspiration has not occurred using the MNT maneuver. If desired, a nasogastric tube can be passed down the unused nostril while ventilation proceeds. The ability to ventilate continuously while performing the fiber-optic intubation is another valuable feature of the technique.

The MNT maneuver can be a valuable addition to our airway armament for the following reasons:

a)mask fit is eliminated as a source of inadequate ventilation,
b) mouth opening and neck manipulation are not required,

c) the technique requires minimal experience, skill, and equipment, and
d) the technique succeeds in establishing an airway after other conventional methods have failed.

Anesth Analg 2002;94:467–9

Labels

Labels:

Comments

  1. AnonymousDecember 30, 2013 at 9:08 PM

    Thanks for posting this information. I tried it today on a thick-bearded individual, it worked wonderful!

    ReplyDelete
  2. AnonymousAugust 5, 2015 at 11:32 PM

    how long can a nasal trumpet stay in?

    ReplyDelete

Post a Comment

Popular posts from this blog

Driving Pressure in ARDS: A new concept!

Driving Pressure and Survival in the Acute Respiratory Distress Syndrome Marcelo B.P. Amato, M.D., Maureen O. Meade, M.D., Arthur S. Slutsky, M.D., Laurent Brochard, M.D., Eduardo L.V. Costa, M.D., David A. Schoenfeld, Ph.D., Thomas E. Stewart, M.D., Matthias Briel, M.D., Daniel Talmor, M.D., M.P.H., Alain Mercat, M.D., Jean-Christophe M. Richard, M.D., Carlos R.R. Carvalho, M.D., and Roy G. Brower, M.D. N Engl J Med 2015; 372:747-755 February 19, 2015 DOI: 10.1056/NEJMsa1410639 BACKGROUND Mechanical-ventilation strategies that use lower end-inspiratory (plateau) airway pressures, lower tidal volumes (V T ), and higher positive end-expiratory pressures (PEEPs) can improve survival in patients with the acute respiratory distress syndrome (ARDS), but the relative importance of each of these components is uncertain. Because respiratory-system compliance (C RS ) is strongly related to the volume of aerated remaining functional lung during disease (termed functional lung size)...
5 comments
Read more

Anaphylaxis updates part 2- Empty Ventricle Syndrome

Patients with anaphylaxis should not suddenly sit, stand, or be placed in the upright position. Instead, they should be placed on the back with their lower extremities elevated or, if they are experiencing respiratory distress or vomiting, they should be placed in a position of comfort with their lower extremities elevated. This accomplishes 2 therapeutic goals: 1) preservation of fluid in the circulation (the central vascular compartment), an important step in managing distributive shock; and 2) prevention of the empty vena cava/empty ventricle syndrome, which can occur within seconds when patients with anaphylaxis suddenly assume or are placed in an upright position. Patients with this syndrome are at high risk for sudden death. They are unlikely to respond to epinephrine regardless of route of administration, because it does not reach the heart and therefore cannot be circulated throughout the body
Post a Comment
Read more

Epidural catheter tests...not only the test dose

Siphon test The catheter is held upright and a fluid level sought. If the catheter is then elevated, the fluid level should fall (see inset) as the fluid siphons in to the epidural space, which is usually under negative pressure compared with atmospheric. If the fluid column continues to rise, this may suggest subarachnoid placement. The siphon test can be reassuring, but is not mandatory. Aspiration  This should be considered mandatory. The Luer connector is attached to the catheter and a syringe is used to apply negative pressure. Free and continued aspiration of clear fluid can indicate subarachnoid placement of the catheter. However, if saline has been used for loss of resistance, it is not unusual for a small amount of this to be aspirated. If there is doubt, the aspirated fluid can be tested for glucose (cerebrospinal fluid will generally test positive) or mixed with thiopentone (cerebrospinal fluid forms a precipitate). If blood is freely and continuously aspirated, this sug...
Post a Comment
Read more