Meconium Aspirator as Airway Suction Device

imagesTo suction/intubate a patient with significant blood, emesis, or secretions within the airway


CONTRAINDICATIONS



imagesContraindications to direct laryngoscopy


SUPPLIES



imagesAll necessary supplies for intubation (see Chapter 1)


imagesEndotracheal tube (ETT) (without stylet, or can use stylet if you have a swivel adapter with a perforated head)


imagesNeonatal meconium aspirator


imagesSuction


TECHNIQUE



imagesAspiration without Stylet


   imagesConnect meconium aspirator to the end of ETT—see FIGURE 5.1


   imagesConnect suction to meconium aspirator


   imagesPrepare for intubation (preoxygenate, assess airway, position, prepare medications, etc.)


   imagesOccluding suction hole of the meconium aspirator with fingertip will allow ETT to function as a large-bore suction device


imagesAlternative: Aspiration with Stylet


   imagesConnect common swivel adapter with a perforated rubber head (Bodai Swivel, Sontek Medical, Hingham, MA) to the end of the ETT—see FIGURE 5.2


   imagesConnect meconium aspirator to swivel adapter and connect suction to meconium aspirator


   imagesETT stylet can be inserted through swivel adapter. See FIGURE 5.3 for complete setup (Figures 5.15.3).


COMPLICATIONS



imagesInability to visualize cords


imagesInability to intubate without stylet (consider using swivel adapter to allow use of stylet in ETT)


imagesClogging of ETT


imagesContamination of ETT


imagesInability to suction


imagesInability to intubate



images


FIGURE 5.1 Meconium aspirator connected to endotracheal tube and wall suction. (Courtesy of Scott D. Weingart and Sabrina D. Bhagwan; used with the permission of Metasin LLC.)

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Aug 9, 2016 | Posted by in EMERGENCY MEDICINE | Comments Off on Meconium Aspirator as Airway Suction Device
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