PubMed · 420975
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L F Tinckler. 1979. A 'universal' tube-holding device.. https://doi.org/10.1002/bjs.1800660119
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In the use of 8% lidocaine pump spray as a lubricant on the Trachlight wand, its print mark was found to have dissolved. We therefore studied this dissolving effect on the print mark with three different types of lubricant (2% lidocaine jelly, 8% lidocaine pump spray and glycerin). One of these lubricants was painted or sprayed on the wand, and after five minutes the surface was wiped with a swab. Both lidocaine jelly and glycerin showed no effect on the print mark, but when lidocaine spray was used, the mark vanished almost completely. The manufacturer recommends that any topical anesthetics or other active ingredients should not be contained in a lubricant used on the Trachlight wand. We conclude that lidocaine pump spray should not be used as a lubricant on the Trachlight wand.
Ayre's T-piece may be used for intubated, non-anaesthetized patients requiring an oxygen supplement or humidified gas mixtures. The system has the disadvantage that atmospheric air (VAD) enters through the expiratory leg when the inspiratory flow and therapeutic gas flow (TGF) are not equal. This admixture can be reduced in the simple T-piece by the addition of either a compliant inspiratory reservoir, or a compliant inspiratory reservoir and an expiratory unidirectional valve. These three systems have been studied in a model investigation using different tidal volumes (VT), respiratory frequencies, and therapeutic gas flow. VAD was measured using a pneumotachograph and the inspiratory tidal volume was measured with a Wright Respiratory Monitor. The ratio VAD/VT was employed as an expression of the admixture of atmospheric air during inspiration. The introduction of a compliant inspiratory reservoir to the simple T-piece results under all conditions in a considerable reduction in VAD/VT. A further reduction was obtained by introducing an expiratory unidirectional valve into the system - however, with the result that the previously open system is turned into a closed system. When selecting a weaning system, the risk to the patient of the discontinuation of the gas flow should therefore be weighed against the advantages obtained by a reduction of the admixture.
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