LETTERS TO THE EDITOR: Letters & Announcements
To the Editor:
We would like to thank Dr. Beattie for describing his interesting experience in the “Cannot Ventilate Cannot Intubate” scenario using a modified trumpet (1).
Five years ago, we reported a similar method (2,3). In contrast to Dr. Beattie’s approach, we used an endotracheal tube placed in a pharyngeal position (like his trumpet). We also used nearly the same grip to seal the mouth and nose. In this study, all of our patients could be ventilated sufficiently, and there was no difference in comparison with mask ventilation. When in different clinical settings an unexpected “Cannot Ventilate Cannot Intubate” situation occurred, we used this method too, until our patients were finally intubated using a fiberscope that was passed through the endotracheal tube. This strategy reduced the possibility of nasal bleeding by 50%.
Both maneuvers can be done easily. Our method does not need another tool (i.e., trumpet) and can be performed anywhere and anytime if one is aware of the technique.
Roland Walz, MD, DEAA
Michael Bund, MD
1. Beattie C. The modified nasal trumpet maneuver. Anesth Analg 2002; 94: 467–9.
2. Bund M, Walz R, Logemann F, et al. Beatmung über einen transnasal plazierten Tubus. Vergleich mit der Maskenbeatmung. AINS 1996; 31: 420–4.
3. Bund M, Walz R, Lobbes W, et al. A tube in the pharynx for emergency ventilation. Acta Anaesthesiol Scand 1997; 41: 529–30.