VENTILATORY MANAGEMENT
DUAL LUMEN DEVICE INSERTION FOLLOWING
AN UNSUCCESSFUL ENDOTRACHEAL INTUBATION ATTEMPT
Start Time:
Stop Time: Date:
Candidate's Name:
Evaluator's Name: Points Points
Possible Awarded
Continues body substance isolation precautions 1
Confirms the patient is being properly ventilated with high percentage oxygen 1
Directs the assistant to pre-oxygenate the patient 1
Checks/prepares the airway device 1
Lubricates the distal tip of the device (may be verbalized) 1
Note: The examiner should remove the OPA and move out of the way when the candidate is prepared to insert
the device
Positions the patient's head properly 1
Performs a tongue-jaw lift 1
USES COMBITUBE USES THE PTL
Inserts device in the mid-line and to the depth Inserts the device in the mid-line until the 1
so that the printed ring is at the level of the bite block flange is at the level of the
teeth teeth
Inflates the pharyngeal cuff with the proper Secures the strap 1
volume and removes the syringe
Inflates the distal cuff with the proper volume Blows into tube #1 to adequately inflate 1
and removes the syringe both cuffs
Attaches/directs attachment of BVM to the first (esophageal placement) lumen and ventilates 1
Confirms placement and ventilation through the correct lumen by observing chest rise, 1
auscultation over the epigastrium and bilaterally over each lung
Note: The examiner states, "You do not see rise and fall of the chest and hear sounds only over epigastrium"
Attaches/directs attachment of BVM to the second (endotracheal placement) lumen and ventilates 1
Confirms placement and ventilation through the correct lumen by observing chest rise, 1
auscultation over the epigastrium and bilaterally over each lung
Note: The examiner states, "You see rise and fall off the chest, there are no sounds over the epigastrium
and breath sounds are equal over each lung"
Secures device or confirms that the device remains properly secured 1
Total: 15
Critical Criteria
Did not take or verbalize body substance isolation precautions
Did not initiate ventilations within 30 seconds
Interrupted ventilations for more than 30 seconds at any time
Did not pre-oxygenate the patient prior to placement of the dual lumen airway device
Did not provide adequate volume per breath (maximum 2 errors/minute permissable)
Did not ventilate the patient at a rate of 10-12 breaths per minute
Did not insert the dual lumen airway device at a proper depth or at the proper place within 3 attempts
Did not inflate both cuffs properly
Combitube - Did not remove the syringe immediately following inflation of each cuf
f
PTL - Did not secure the strap prior to cuff inflation
Did not confirm, by observing chest rise and auscultation over the epigastrium and bilaterally over each
lung that the proper lumen of the device was being used to ventilate the patient
Inserted any adjunct in a manner that was dangerous to the patient
