Endotracheal tube (ETT) displacement can become a catastrophic event in surgeries where in anesthesiologists are away from the surgical field, and where easy access to the ETT is difficult. Hence, the fixation of endotracheal tube by securing adhesive tapes is of utmost importance as it not only provides effective ventilation but also minimizes complications due to re‐interventions.[1,2] The desired qualities of these tapes are good quality adhesive material, water‐resistant nature, non‐toxic, non‐irritant, non‐allergic material, easy availability and being economical.

Endotracheal tube fixation: Still a dilemma.

Endotracheal Tube Fixation via a Modified Ivy Loop in a Pediatric Patient With Facial Burns: A Technical Note.

Establishing a secure airway is critical in the acute phase of facial burns. This case report involving a 9-month-old infant with facial burns describes two techniques of securing an oral airway - trans-alveolar wiring and the application of an intermaxillary fixation (IMF) screw. The use of an IMF screw was more reliable than trans-alveolar wiring, as it allowed a secure airway through the patient's hospitalization, which involved 7 additional surgical interventions including 5 separate facial skin grafts over a 3-month period.

Oral endotracheal tube stabilization for facial burns in infants - Report of 2 techniques.

Airway management in children with severe burns is difficult because of airway edema and prolonged duration of ventilatory management. There is insufficient evidence to suggest that tracheostomy is beneficial for children.A male child aged 1 year and 4 months was injured when he accidentally fell into a bathtub filled with boiling water. Furthermore, 85% of the burnt area, including the face and neck, consisted of second-degree burns; hence, oral tracheal intubation and resuscitative infusion were required. In this case, the patient was safely switched from oral to nasotracheal intubation using a tracheal tube guide and video laryngoscope, without the use of a bronchoscope, and ventilatory management could be continued for 2 weeks.Oral to nasal endotracheal tube exchange using a tracheal tube guide and video laryngoscope may be useful not only for pediatric burn patients but also for adult patients who need to be safely switched from oral to nasotracheal intubation. 

/pdf/oral-to-nasal-endotracheal-tube-exchange-using-tracheal-tube-vmvn6im9.pdf

Oral to nasal endotracheal tube exchange using tracheal tube guide and video laryngoscope in a pediatric patient with facial burns: a case report

Airway management in both acute and reconstructive burn patients can be a major challenge for evaluation, intubation, and securing the airway in the setting of altered airway structure. Airway evaluation in both acute and reconstructive patients includes examination for evidence of laryngeal and supraglottic edema and structural changes due to trauma and/or scarring that will impact the successful approach to acquiring an airway for surgical procedures and medical recovery. The approach to acquiring a successful airway is rarely standard laryngoscopy and often requires fiberoptic bronchoscopy and a variety of airway manipulation techniques. Tracheostomy should be reserved for those with classic requirements of ventilatory and/or mechanical failure or severe upper airway burns. Even securing an airway for surgical procedures, especially with patients suffering injuries involving the head and neck, can be nonstandard and requires creative and flexible approaches to be successful. After much trial and error over the past 30 years in a large burn center, our multidisciplinary team has learned many valuable lessons. This review will focus on our current approach to safe airway management in acute and reconstructive burn patients.

Airway Management for Acute and Reconstructive Burns: Our 30-year Experience

Endotracheal Tube Fixation in Patients With Facial Burns, What Are the Options?

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Endotracheal Tube Fixation in Patients With Facial Burns, What Are the Options?