The esophageal-tracheal double-lumen airway: rescue for the difficult airway

A rescue airway device is used when conventional methods of intubation fail to achieve control of the airway. Although the laryngeal mask airway is often used in the operating room should endotracheal intubation fail, the esophageal-tracheal double-lumen airway represents another alternative rescue airway device. Nurse anesthetists may encounter patients with an in situ esophageal-tracheal double-lumen airway placed in the field; in some locales, it is used as the primary approach to airway management by emergency services personnel. The most commonly used esophageal-tracheal double-lumen airway device is the Combitube (TYCO Healthcare, Pleasanton, Calif), which will be used to illustrate insertion techniques needed in the use of esophageal-tracheal double-lumen airways. Nurse anesthetists should familiarize themselves with the function and placement of the device in case it is needed.