Abstract
We write regarding a recent situation whereby wefound ourselves in a clinical situation in needof confirmation of a tracheal tube position. Chest radiographs were inconclusive, and while direct laryngoscopy was an option, the increased sedation and muscle relaxation required meantthat our preferred option was endoscopic examination.
Unfortunately, the only fibre optic endoscope immediately available to us was an intubating fibre optic endoscope with a battery-operated light source. During the preparation of the ‘scope, we identified that the light source was missing, and enquiries to the operating department practitioners were unfruitful.
Prior to escalating to direct laryngoscopy, we decided to try a novel approach to establishing a light source for our ‘scope.
We used a standard disposable pen torch (Merlin Medical, Gwent, UK) inserted into the light source port as illustrated in Figure 1(a) and (b). The torch was secured in position using tape, and the switch was taped down in the ‘on’ position.
(a) Side view of pen torch insertion into light source. (b) Front view of pen torch insertion into light source.
This setup provided adequate illumination to confirm the position of the tracheal tube relative to the carina, which eliminated the need for direct laryngoscopy.
While we would always recommend using the standard light source supplied by the manufacturer, the setup we describe could be considered in an emergency situation.