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• W2330649343 abstract "Introduction/Background While preparing for a simulation scenario involving one lung ventilation, we realized that it was impossible to properly place a double lumen endobronchial tube in our Laerdal SimMan 3G manikin. The left sided tube could not be advanced far enough to provide proper lung separation. Upon investigation of the manikin’s airway anatomy, we discovered that the connector used at the takeoff of the left main stem bronchus and the tubing leading to the manikin’s lung, was blocking the path of the endobronchial tube. In an attempt to overcome this problem, we devised a different connection, which allows for the proper placement of a left sided double lumen endobronchial tube. Methods The easiest solution was to find a connector that would fit on the outside of the tubing rather than the inside. Therefore, we needed to find a possible replacement connector. After consulting with our Respiratory Therapy Department, we chose a 22 mm flexible rubber adapter (RC Medical, Inc.), which actually has a measurable inner diameter of 18 mm and costs $3.94. Once the manikin’s lungs were exposed, we cut the tie wrap securing the connection between the left bronchus and the clear tubing leading to the left lung bag, pulled the connection apart and removed the original connector. With the manikin’s left main stem still disconnected from the lung tubing, we inserted a size 35 left sided double lumen endobronchial tube through the manikin’s oral cavity via direct laryngoscopy. It was still difficult to advance the tube as far as needed. Therefore, we used a surgical clamp to grab the tip of the tube and pull it down far enough to be in the proper position, which we checked using a flexible fiber optic scope. The new connector was then put in place over the left main stem bronchus (which now had about 1 cm of the endobronchial tube protruding from it). Then we inserted the clear tubing from the lung into the other side of the connector, replaced the chest plate and skin, and we were ready for our one lung ventilation scenario. Results: Conclusion We were able to correctly place a left sided double lumen endobroncheal tube in our Laerdal SimMan 3G manikin after making a small modification to the left lung connection. This allowed us to run our scenario, which started out with our patient anesthetized, turned on his right side, undergoing one lung ventilation with a double lumen endobronchial tube. Simulation manikins that are currently available on the market may not always be able to accommodate a particular medical situation. Simulation personnel should not be hesitant to explore their manikin’s anatomy, use some common sense, and develop an easy, inexpensive solution to a problem that will allow them to accomplish the goal of the scenario without compromising the mannequin’s performance. Disclosures None." @default.
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• W2330649343 date "2013-12-01" @default.
• W2330649343 modified "2023-09-27" @default.
• W2330649343 title "Board 550 - Technology Innovations Abstract A Simple Modification to Your Laerdal SimMan 3G Manikin that will Allow the Correct Placement of a Left Sided Double Lumen EndoBronchial Tube (Submission #519)" @default.
• W2330649343 doi "https://doi.org/10.1097/01.sih.0000441748.99856.54" @default.
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