Potential Disaster in Airway Management: A Misguided Airway Exchange Catheter via  a Hole Bitten into a Univent Endotracheal Tube

Tube-in-tube Emergency Airway Management after a Bitten Endotracheal Tube Caused by Repetitive Transcranial Electrical Stimulation during Spinal Cord Surgery

“…Several publications have associated the use of wirereinforced tubes with airway complications such as perforation, 5,6 occlusion, 7 obstruction, 8,9 or dissection. 10 There is only a single report of a bitten and consecutively leaking tube caused by jaw muscle contraction after TES 11 and a single report of tube obstruction while the patient was in prone position.…”

Custom Built Bite-Block Endotracheal Tube Holder for Prolonged Intubation

“…To avoid the complications of biting on the ETT, many clinicians strongly suggest the use of shields or bite-blocks. Despite this precaution, there are still case reports describing a damaged or occluded ETT [1][2][3][4] . There is commonly a limited range of bite-block sizes available and a poor fit for the patient's requirements is common.…”

“…To reduce the risk of obstruction due to the patient biting on the ETT, many forms of shields and bite-blocks, both intra-and extra-oral, have been devised. Despite this, there are still reports of life-threatening airway obstruction or damaged ETTs due to patients' biting on the ETT [1][2][3][4] . When bite-blocks are utilized, access to the oral cavity for oral care can be greatly compromised [5][6][7] .…”

Use of WuScope for Exchange of Endotracheal Tube in a Patient With Difficult Airway

“…9 Although the AEC has been reported to be easy to use, 10,11 failed ETT exchange has occurred with this method. 8,12 Mort 8 reported the use of the AEC in 98 patients; 60% of them developed hypoxemia, 8% developed bradycardia, one patient had cardiac arrest, and two patients required surgical airway. In addition, there have been reports of serious complications from AEC use including endobronchial rupture.…”