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A submental endotracheal tube is an option in patients undergoing oral surgery in which a nasal tube is contraindicated, and a tracheostomy is undesirable.
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Mar 12, 2012
If requiring intubation for a CT scan or angiography, it may be appropriate to transfer the patient to theater first to secure the airway in the safest possible environment.
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Oct 17, 2011
If the surgeon wants a nasal ETT and no postoperative tracheostomy will be required, review the CT scan with surgeon, and if it is thought that it is unlikely to exacerbate the injury, consider a nasal ETT. Insert either by performing a RSI (to avoid ventilation and pneumocephalus), or cautious, awake, fibreoptic technique.
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Oct 17, 2011
If the surgeon wants no oral tube, and patient WILL require a post operative tracheostomy, look at scans with surgeon, and airway assessment of the patient, and consider the suitability of rapid sequence induction followed by formal tracheostomy. "Rapid" oral intubation aims in this instance is to minimise or avoid mask ventilation which could result in pneumocephalus or meningitis.
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Oct 17, 2011