Guedel tube | Intubation

Guedel tube

The Guedel tube is like the laryngeal mask an oropharyngeal tube. It serves to facilitate mask bag ventilation. The Guedel Tube is inserted through the mouth of an unconscious/anaesthetised patient and is placed in the throat.

This prevents the airways from being blocked, for example by a slackened tongue. The Guedel Tube cannot be used in awake patients, as otherwise protective reflexes are triggered during insertion, which can lead to vomiting and subsequent aspiration. The correct length is selected based on the distance between the corner of the mouth and the patient’s earlobe.

Coil tube

The spiral tube, like the Guedel tube, is used to facilitate mask bag ventilation. However, it is a nasopharyngeal tube, i.e. it is advanced through the patient’s nose and into the throat. This means it can also be used with awake patients. To select the correct length, the distance between the tip of the nose and the patient’s earlobe is used as a guide.

Endotracheal Intubation

Endotracheal intubation is the procedure of choice for emergency or fasting patients. It is used for operations on the head, neck, chest and abdomen. In principle, there are no contraindications, especially for emergency procedures.

Endotracheal intubation involves the insertion of a breathing tube into the patient’s windpipe. Tubes with a thickness of 7.0-7.5mm are used for women, while tubes with a thickness of 8.0-8.5mm are used for men. When intubating small children, the thickness of their little finger is used as a guide for the thickness of the tube to be selected.

Procedure First, the patient is ventilated with a mask to ensure that his blood is sufficiently enriched with oxygen. After administration of a muscle-relaxing medication (muscle relaxant), the so-called laryngoscope can first be pushed towards the larynx. A camera is attached to the laryngoscope, through which the anesthetist can see the larynx.

The epiglottis can then be raised with the laryngoscope until the vocal cords are visible. Then the ventilation tube can be inserted into the windpipe past the vocal cords and ventilation can begin. A bite guard can subsequently be inserted to prevent the patient from accidentally biting the tube.

The tube is then fixed to the mouth with strips of plaster.Complications Due to certain anatomical conditions, the vocal cords of some patients may not be readily visible. In such cases, an attempt is first made to improve visibility by carefully pressing the larynx upwards and to the right. This procedure is called BURP maneuver (backward, upward, rightward pressure). If intubation is still not possible, alternative procedures may have to be used.