Section I. ESOPHAGEAL OBTURATOR AIRWAY
2-1.
INTRODUCTION
Intubation, a valuable technique, is used frequently in the administration of
anesthesia, cardiopulmonary resuscitation, and respiratory therapy. The procedure
improves safety by establishing and maintaining the casualty's airway, allowing the
surgeon greater freedom of access to the operative field, and improving aseptic
technique for head and neck surgery. However, the procedure requires both a
knowledgeable and skillful medical specialist. The esophageal obturator airway (EOA)
is a long tube open at the top, sealed at the bottom, with numerous side holes near its
upper end. The esophageal gastric tube airway (EGTA) is a variation of the EOA. It
has no holes on the tube, but the tip of the obturator is open rather than closed. The
technique for passing (inserting) the EOA and the EGTA are the same. Neither the
EOA nor the EGTA provides the perfect answer to controlling the airway and neither
should be considered as replacements for endotracheal intubation (ET). Their most
appropriate use is as an interim form of airway control in patients who are difficult to
intubate endotracheally.
2-2.
PURPOSE OF THE EOA AND EGTA
The esophageal obturator airway and the esophageal gastric tube airway have
several important purposes. Each device, when inserted, holds the tongue away from
the pharynx allowing ventilated air to move through the trachea into the lungs.
Additionally, the EOA and the EGTA, when inserted, seal off the stomach from the
airway thus preventing gastric acid from coming back into the pharynx. The EGTA can
be used for gastric lavage (washing out the stomach) and gavage (forced feeding by
flexible tube and pump).
2-3.
ADVANTAGES/DISADVANTAGES OF THE EOA AND EGTA
a. Advantages of EOA and EGTA. There are two main advantages in using
these devices. First, both the EOA and the EGTA are easy to place. Second, only
minimal training is required to learn to place the devices properly.
b. Disadvantages of EOA and EGTA. These are the disadvantages. Theses
devices DO NOT allow a direct pathway into the larynx for suctioning. The mask face
seal must be good for ventilation. It is possible to cause pharyngeal trauma to the
patient during insertion of the device. It is possible to accidentally enter the trachea and
totally obstruct the airway. Finally, if the cuff of the EOA is not properly inflated, gastric
distention and impaired ventilation can be caused. Neither of these devices should be
used on anyone less than five feet tall; the tubes are too long for people of such height.
MD0569
2-2
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