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In its basic (standard) version, the laryngeal tube is made up of a tube with a larger balloon cuff in the middle (oropharyngeal cuff) and a smaller balloon cuff at the end (oesophageal cuff). The tube is kinked at an angle of 30-45° in the middle; the kink is located in the larger cuff.
The tube may be difficult to position, particularly in an unwell patient, and may inadvertently be inserted in the trachea, hence endotracheal intubation before the procedure is strongly advised to secure the airway. The tube is often kept in the refrigerator in the hospital's emergency department, intensive care unit and gastroenterology ward.
In the prehospital emergency setting, digital intubation may be necessitated if the patient is in a position that makes direct laryngoscopy impossible. For example, digital intubation may be used by a paramedic if the patient is entrapped in an inverted position in a vehicle after a motor vehicle collision with a prolonged extrication time.
For an inflatable cuff, the cuff should be inflated and deflated outside the patient to ensure it is functional. [1] A pen-like grip is used to move it through the patient's mouth and throat, preferably when their head is extended to straighten the airway. [1] The laryngeal mask airway should be lubricated so that it can be placed more easily. [1]
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Inflation of the cuff in the esophagus allows a level of protection against aspiration of gastric content similar to that found in the laryngeal mask. [2] The simplicity of placement is the main advantage of the Combitube over endotracheal intubation. When intubating with a traditional endotracheal tube, care must be taken to visually ensure ...
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