ETT Stylet

OVERVIEW

  • ETTT stylet is a device that allows the endotracheal tube (ETT) to be stiffened and the shape moulded as desired.

USE

  • alters the shape of an ETT  to facilitate intubation
  •  stiffens the ETT to aid passage into the trachea

DESCRIPTION

  • curved proximal tip that hooks over the end of the universal connector to prevent the distal stylet tip from extending beyond the tip of the ETT
  • Polyethylene coated malleable aluminium
  • Single use available in different lengths appropriate for different tube sizes

METHOD OF INSERTION/ USE

  • lubricate stylet with water soluble gel
  • insert stylet into ETT
  • bend the stylet into the desired shape
  • optimal shape for intubation direct laryngoscopy is ‘straight-to-the-cuff’ with a a ‘hockey stick’ bend at the cuff of no more than 35 degrees
  • ETT is inserted from the right side of the patient’s mouth to maximise your view and provide optimal control of the position of the tip of the endotracheal tube
Photo by Reuben Strayer/ emupdates.com (click image for source)

Photo by Reuben Strayer/ emupdates.com (click image for source)

COMPLICATIONS

  • Trauma due to protrusion of the stylet tip beyond the end of the ETT
  • inadvertent removal of the ETT when removing the stylet

OTHER INFORMATION

  • different brands and sizes available, including pediatric sizes
  • if a stylet is used for video laryngoscopy different conformations may be optimal depending on the type of video laryngoscope/ blade
  • traditional arcuate shaped stylets/ ETTs may obscure the view of the ETT tip on insertion and cause the tip of the ETT to abut against the inner surface of the anterior trachea once the passed through the cords

This video by Levitan/ Airwaycam.com shows the benefit of the straight-to-cuff stylet shape:

Stylets and bougies by Tim Leeuwenberg:

References and Links

  • Foote C, Steel L, Vidhani K, Lister B, MacPartlin M, Blackwell N. Examination Intensive Care Medicine (2nd Edition), Elsevier 2011. [Google Books Preview]

  • Levitan RM, Pisaturo JT, Kinkle WC, Butler K, Everett WW. Stylet bend angles and tracheal tube passage using a straight-to-cuff shape. Acad Emerg Med. 2006 Dec;13(12):1255-8. Epub 2006 Nov 1. PubMed PMID: 17079788.

 

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