ETT Stylet

OVERVIEW

  • ETT stylet is a device that allows the endotracheal tube (ETT) to be stiffened and the shape molded as desired.

USE

  • alters the shape of an ETT to facilitate intubation
  • stiffens the ETT to aid passage into the trachea

DESCRIPTION

  • curved proximal tip that hooks over the end of the universal connector to prevent the distal stylet tip from extending beyond the tip of the ETT
  • Polyethylene coated malleable aluminum
  • Single use available in different lengths appropriate for different tube sizes

METHOD OF INSERTION/ USE

  • lubricate stylet with water soluble gel
  • insert stylet into ETT
  • bend the stylet into the desired shape
  • optimal shape for intubation direct laryngoscopy is ‘straight-to-the-cuff’ with a a ‘hockey stick’ bend at the cuff of no more than 35 degrees
  • ETT is inserted from the right side of the patient’s mouth to maximise your view and provide optimal control of the position of the tip of the endotracheal tube
stylet-from-the-side
Photo by Reuben Strayer/ emupdates.com

COMPLICATIONS

  • Trauma due to protrusion of the stylet tip beyond the end of the ETT
  • inadvertent removal of the ETT when removing the stylet

OTHER INFORMATION

  • different brands and sizes available, including pediatric sizes
  • if a stylet is used for video laryngoscopy different conformations may be optimal depending on the type of video laryngoscope/ blade
  • traditional arcuate shaped stylets/ ETTs may obscure the view of the ETT tip on insertion and cause the tip of the ETT to abut against the inner surface of the anterior trachea once the passed through the cords

This video by Levitan/ Airwaycam.com shows the benefit of the straight-to-cuff stylet shape:


Stylets and bougies by Tim Leeuwenberg:

https://vimeo.com/56663118

CCC Airway Series

  • Levitan RM, Pisaturo JT, Kinkle WC, Butler K, Everett WW. Stylet bend angles and tracheal tube passage using a straight-to-cuff shape. Acad Emerg Med. 2006 Dec;13(12):1255-8. PMID: 17079788.

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the  Clinician Educator Incubator programme, and a CICM First Part Examiner.

He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.

His one great achievement is being the father of three amazing children.

On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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