Quick Guide: Combitube

Esophageal/Tracheal Double-Lumen Airway

Step 1
Place the patients head in neutral position.
Open the mouth and depress tongue.
Insert the Combitube

airway fat along the tongue.
Continue until the patients front teeth are aligned between the depth marks.

Step 2
First, use the large syringe to infate the blue pilot balloon for the large
oropharyngeal cuff. Infate to 85 mL (37 Fr) or 100 mL (41 Fr).
Then, use the smaller syringe to infate the white pilot balloon for the distal
cuff. Infate to 12 mL (37 Fr) or 15 mL (41 Fr).
During infation, the Combitube airway might move slightly out of the patients
mouth due to the self-adjusting property of the oropharyngeal balloon.

Step 3
Assume esophageal positioning.
Attach ventilating device to the longer, blue connecting tube.
If auscultation of breath sounds is positive, continue ventilation.
Confrm tracheal ventilation with end-tidal CO
2
detection.
Use the shorter, clear connecting tube for gastric suctioning.

Step 4
If auscultation of breath sounds is negative, attach breathing device to the
shorter, clear connecting tube and ventilate.
Confrm tracheal ventilation with auscultation of breath sounds and end-tidal
CO
2
detection. The Combitube airway is functioning as a tracheal tube in this case.

Step 5
COMBITUBE

ESOPHAGEAL/TRACHEAL DOUBLE-LUMEN AIRWAY

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B.k 3153v1-1008 AW09306
6135 Gunbarrel Avenue
Boulder, CO 80301
USA
303-530-2300 [t]
303-305-2211 [f]
www.covidien.com
Customer Service
800-635-5267
The Combitube airway is designed for use for
up to eight hours. If longer intu ba tion
is necessary, replace with a standard endo-
tracheal tube. To replace the Combitube airway
in esophageal placement with a standard
endotracheal tube:
Defate the oropharyngeal cuff through the
blue pilot balloon.
Move the Combitube airway to the left side
of the mouth.
Intubate with an endotracheal tube using
currently accepted medical techniques.
Defate the distal cuff through the white pilot
balloon and remove carefully, making sure to
maintain a patent airway.
Available in Two Sizes
Size O.D. Use
37 Fr For patients 4 ft to 6 ft (122 to 183 cm) tall
41 Fr For patients more than 5 ft (152 cm) tall
Either size can be used with patients between 5 ft and 6 ft tall
37 Fr Either size 41 Fr
4 ft (122 cm) 5 ft (152 cm) 6 ft (183 cm)
Pharyngeal lumen
Oropharyngeal cuff
Due to the material characteristics
(e.g. texture) of the oropharyngeal
cuff, the Combitube airway requires
considerable force to dislodge,
ensuring secure placement.
1
Esophageal/tracheal distal cuff
The robust distal cuff exhibits zero
leakage around the cuff at 30 cm
H
2
O simulated gastric pressure.
1
1
Results based on internal testing
Depth marks
Rounded atraumatic tip
Rounded tip is designed to
prevent tissue trauma upon
insertion. The Combitube airway
has been shown to be atraumatic
in more than 200 clinical studies.
Ventilating eyes
Eight ventilation apertures help
ensure optimal ventilation. If one
of the openings becomes clogged,
ventilation can still easily occur
through the other seven openings.
Esophageal/tracheal lumen