OBTURATING INTRODUCER FOR NASAL ENDOTRACHEAL TUBES

Benefits of the obturating introducer for nasal endotracheal tubes include:

• Reduced epistaxis incidence and severity to the same or less than the incidence when using a red rubber catheter.
• Reduced incidence of nasopharyngeal soft tissue damage and nasal pain post intubation. The device eliminates the sharp edges associated with the bevel and at the end of an endotracheal tube, and creates a smooth atraumatic contour.
• Simple to use. Passage of a bevelled endotracheal tube through the nasopharynx requires supervision and experience before complications can be minimized. This device makes passage through the nasopharynx a simple technique. If the catheter passes from the nasopharynx to the oropharynx so will the endotracheal tube.
• Different sizes to fit different diameter endotracheal tubes. Range 5 – 8.0mm internal diameter.
• The proximal end of the intubation device is manufactured to connect with an endotracheal tube with a posterior facing bevel that allows for easier placement of the endotracheal tube in the trachea without the need for rotation.
• Push pull method of insertion and fit of catheter to tube allow for introduction of wide variety of endotracheal tubes including flexible reinforced endotracheal tubes.
• Soiling of the lumen of the endotracheal tube in the passage through the nasopharynx is prevented as the introducing device obturates the apertures of the endotracheal tube.
• Most endotracheal tubes have left facing bevels designed to be safer passed through the right nostril. Using the introducer means that the most suitable nostril may be chosen to intubate.
• The external diameter of the complex passed through the nose remains the same as the external diameter of the endotracheal tube. Use of a red rubber or modified urethral catheter increase the external diameter. Increasing external diameter is associated with an increasing incidence of epistaxis.
• All Genesis airway endotracheal tubes have posterior facing bevels with a curved atraumatic tip shown to be safer when passed through the nasopharynx and to provide a greater initial success rate of intubation when railroaded over a bougie or fibreoptic scope.
• All Genesis airway endotracheal tubes have high volume low pressure cuffs.
• Genesis airway RAE endotracheal tubes sizes 8.5 – 6.0mm ID are made from soft PVC reducing nasal trauma and preventing the need for thermo-softening.

Studies that support the use of the obturating introducer for nasal endotracheal tubes include:
16, 20, 23, 24, 39 40 41