Guedel tube
The Guedel tube , an oropharyngeal tube , is an aid to keeping the airways free. It was presented in 1933 by the American anesthetist Arthur Ernest Guedel .
It is used (in the absence of appropriate defense reflexes) to keep the upper airways open.
A Guedel tube consists of a flattened, hard plastic tube (formerly also rubber), which has a round support surface ("shield") on one side, to which a straight piece of tube about 2-3 cm long is connected. Behind it begins a curved piece, which initially describes a semicircle upwards, which extends in an extended radius over the imaginary base line of the straight piece down about 1–2 cm.
The Guedel tube is inserted with the end up (towards the head) into the oral cavity, pushed along the tongue and then rotated 180 ° into its end position, which pushes the base of the tongue forward.
For emergency medicine , Guedel tubes are typically provided in sets of up to nine different sizes (000 to 5) for newborns, children and adults. The different sizes can partly be identified by their different colors, although different manufacturers use different color codes.
When the tube is inserted into the oral cavity, the shield comes to rest in front of the lips, the teeth lie on the straight piece. The arch corresponds to the curvature of the lower jaw with the tongue resting on it and extends to the base of the neck (in the direction of the windpipe ). This shape clears the tongue from the airway and removes the obstacle to breathing, as it falls back in an unconscious person and obstructs the airway. The Guedel tube is used, among other things, for mask ventilation by means of a ventilation bag in emergency and intensive medicine as well as anesthesia. It can also serve as a bite guard for endotracheally intubated patients in order to prevent the teeth from damaging or narrowing the endotracheal tube (which can also be attached to the Guedel tube) .
Possible dangers arise from a Guedel tube that is too long, which causes the airway to be blocked by pressure on the epiglottis, or from a tube that is too short, in which the base of the tongue can slide between the tube opening and the larynx and which can also obstruct the airway. If the patient is not deeply unconscious, especially if used carelessly, coughing, choking, vomiting and glottic cramps can be triggered.
The Wendl tube has a similar function, but is inserted through the nose.
literature
- McIntyre JW. Oropharyngeal and nasopharyngeal airways: I (1880-1995). Can J Anaesth. 1996 Jun; 43 (6): 629-35. PMID 8773872 .
- Flake / Runggaldier: Working techniques AZ for the rescue service: picture atlas rescue service. Elsevier, Munich, 2008. ISBN 978-3437483202 .
- Walied Abdulla: Interdisciplinary Intensive Care Medicine. Urban & Fischer, Munich a. a. 1999, ISBN 3-437-41410-0 , p. 6 f.
Web links
Individual evidence
- ^ Arthur Ernest Guedel: A nontraumatic pharyngeal airway (Clinical Notes, Suggestions and New Instruments). In: JAMA . tape 100 , 1933, pp. 1862 .