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Friday, March 13, 2009

ETT holders work wonders

The worse codes are those that take place in unexpected places -- like CT.

The call was overhead: "Code Blue to CT!"

I rushed to CT to find a patient already intubated. The anesthesiologist was standing at the head of the bed holding an unsecured ETT.

As soon as he saw me he gave me that job, and now I was standing there at an awkward angle with someone breathing down my back in the closed in room holding the ETT in place.

The funny thing I had no idea where this patient came from. Then I realized it was not a patient from ER (of course not, I would have known), it was a surgical patient the doctor decided needed a CT.

The ETT, I noticed, was secured only with tape. Something ACLS does not recommend when you are transporting a patient. Something common sense does not recommend when you are transporting a patient.

Suddenly I hear the following: "On a count of three: one..."

"Wait!" I say



"...three... heave!"

"Shit!" the patient slid down the table and my feet and my hands stayed firm in the position they were in holding the ETT....

Only now the ETT was no longer in the patient.

The anesthesiologist said nothing. He easily and calmly reintubated. And, at which time, I secured the airway with a good solid and firm bite block or ETT holder or whatever you want to call it.

When I was finished I admired my work. "See doc," I said, tugging on the tube to indicate it was secure, "This is how you secure an ETT!"

He smiled.

The old technique may have worked fine in the day, but now that we have access to better research and better equipment, we might as well use it.

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