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

Comments

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

    ReplyDelete
  2. how long can a nasal trumpet stay in?

    ReplyDelete

Post a Comment

Popular posts from this blog

power injectable peripherally inserted central catheters

Clinical experience with power injectable peripherally inserted central catheters in intensive care patients     Introduction In intensive care units (ICU), peripherally inserted central catheters (PICC) may be an alternative option to standard central venous catheters, particularly in patients with coagulation disorders or at high risk for infection. Some limits of PICCs (such as low flow rates) may be overcome by the use of power-injectable catheters . Method We have retrospectively reviewed all the power injectable PICCs inserted in adult and pediatric patients in the ICU during a 12-month period, focusing on the rate of complications at insertion and during maintenance. Results We have collected 89 power injectable PICCs (in adults and in children), both multiple and single lumen. All insertions were successful. There were no major complications at insertion and no episodes of catheter-related blood stream infection. Non-infective complications ...

Things to Avoid in Anesthesia for Pregnant with Pulmonary hypertension

Anesthesia for Pregnant woman with Pulmonary Hypertension is a real challenge for anesthesiologist. It is very crucial to remember the pathophysiology of pulmonary hypertension in pregnant women and to avoid some practices that will worsen the cardiac status. 1-Avoid single shot spinal anesthesia. Some authorities consider pulmonary hypertension as absolute contraindication for single shot spinal anesthesia specially in patients with NYHA III ,IV. Spinal anesthesia causes major hemodynamic instability(decrease SVR, decrease VR, decrease in CO) The preferred neuroaxial techniques are (epidural anesthesia and CSE with minimal spinal dose) 2-Avoid PAC. Pulmonary Artery catheters insertion may lead to pulmonary artery rupture or thrombosis. TEE is better cardiac monitor/Arteial line is mandatory. 3-Avoid Nitrous oxide in gas mixture.N2O increase the PVR 4-If MV to be started, avoid High TV and PEEP 5-Avoid Oxytocin Boluses, or rapid administration of Pitocin. Oxytocin causes ...

Steroids In Perioperative period...The Multi-purpose Drugs

1-Steroids are not Bronchodilator ,but have well established usefulness in hyper-reactive airway. They are also said to have a permissive role for bronchodilator medication. They can be administered orally, parenterally or in aerosol form 2- Steroids have been commonly used in chemotherapy for prevention of nausea along with other anti-emetic agents . Dexamethasone was found to be highly effective when given immediately before induction rather than at the end of anesthesia . 3- Steroids do exert analgesic effects. Various routes of administration of steroids include parentral, local infiltration at operated site , as an adjuvant in nerve blocks and central-neuraxial blockade. 4 - Steroids cannot be the mainstay of therapy in anaphylaxis because of the delayed onset of action, so they are used as adjunct after initial treatment with epinephrine. 5- Steroids (Dexamethsone) are of value in reduction or prevention of cerebral edema associated with parasitic infections and neopla...