Category Archives: AirwayHowTo

AirwayHowTo, Supraglottics

Quick Tip: IntraOp Temperature Monitoring with a 2nd generation SGA

Without getting into a lengthy argument about what constitutes a second-generation supraglottic airway (or an extraglottic vs. supraglottic, for that matter), if you are using an SGA with a gastric drainage port (such as the LMA Proseal, LMA Supreme, i-Gel, etc) you have a very simple and easy conduit to insert a mid-oesophageal thermistor probe to monitor patient temperature.

Mid-oesophageal temperature probe inserted via the gastric drainage tube of an LMA Supreme
Mid-oesophageal temperature probe inserted via the gastric drainage tube of an LMA Supreme

Ideally, to achieve a mid-oesophageal position, you need the probe to extend 5-10 cm past the tip of the SGA, so try and remember to measure the probe against the device before insertion and mark it with a small piece of dressing tape.  This has an added advantage of helping prevent air leak via the drainage tube if your SGA is not seated or strapped ideally.   Of course, this means that drainage via the oespophageal lumen is significantly impaired, and you cannot insert a gastric tube without removing the probe first, so it is only suited to patients in whom you have little concern regarding reflux and aspiration.  Devices that offer twin drainage tubes (such as the 3gLM) are a way around this problem.

AirwayHowTo, Endoscopy

AirwayHowTo: Leak test a flexible endoscope

Video

Flexible fibreoptic and video endoscopes are fantastic but expensive pieces of equipment. In order to be maintained in top working condition, they need a little tender loving care. A particular problem occurs when the sheath of the scope becomes damaged or cracked, allowing fluid (especially corrosive cleaning solutions) to enter the inner workings of the scope, causing irreparable damage. The inner workings of the scope are a sealed environment. The patency of the seal – and thus the presence or absence of any damage – can easily be determined by performing a leak test. Although this is usually performed by medical technologists who are looking after the scopes, it can just as be performed quickly by the user while the scope is being prepared, or just before cleaning. Spend 100 seconds watching this brief, unadorned video which will walk you through the process. The demonstration here is using our Storz equipment, but is very similar regardless of the make or model of endoscope.