Correspondence

41 1

A complication of guided blind intubation The complication of guided blind intubation' described by Akinyemi & John (Anaesthesia, 1974, 29, 733) was caused by the unsatisfactory construction of the hook which they used initially. A suitable hook is shown in the Figs 1 & 2 and is constructed by bending the tip of a blunt tipped metal introducer customarily used for the insertion of infant flexometallic tubes.

Fig. 2.

When an epidural catheter is introduced into the pharynx as in Waters' method, it coils up in circular fashion and becomes applied to the lateral walls of the pharynx as shown in the Radiograph (Fig. 3). This makes extraction of the catheter very easy. The hook is passed along the medial and inferior part of the nose with its tip facing caudally. When the hook makes contact with the posterior pharyngeal wall it is rotated so that the tip faces laterally, then keeping close contact with the lateral wall of the nasopharynx and nose the hook is slowly withdrawn; almost invariably the catheter will be retrieved at the first attempt; subsequently the procedure is as originally described by Waters. I am indebted to the Department of Medical Illustration, Westminster Hospital, for the photographs, and to Dr John Inkster for the radiograph. Magill Department of Anaesthetics, Westminster Hospital, Page Street, London S WI P 2AP

CYRIL SCURR

412

Correspondence

Fig. 3.

Reference 1. WATERS,D.J. (1963) Guided blind intubation for patients with deformities of the upper jaw. Anaesthesia, 18, 158.

A modified Magill nasal connector Some while ago during the course of anaesthesia for dental surgery I was unfortunate enough to ‘lose’ a nasotracheal tube off its Magill connection. The tube disappeared down the nose and was eventually retrieved through the mouth. It seemed to me that such mishaps could be avoided by considerably lengthening the intratubal portion of the connection. Figure 1 shows such a lengthened connection in comparison to the standard product. These modified connections have proved very satisfactory in use. The photograph shows a slight ridge on the connection which marks the point at which the extra length of metal tubing was brazed on. This ridge will not be present on the commerically made connections, which will be available from Medical and Industrial Equipment Ltd., Broadwick Street, London W1 A 2AD. Department of Anaesthesia, Poole General Hospital, Longfleet Road, Poole, Dorset

F. M. FREW

Letter: A complication of guided blind intubation.

Correspondence 41 1 A complication of guided blind intubation The complication of guided blind intubation' described by Akinyemi & John (Anaesthesia...
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