Airway Equipment:

Waveform Capnography:

See Appendix G for Capnography Interpretation

Heat-Moisture Exchanger:

Heat-Moisture Exchangers (HME) are small, relatively inexpensive, in-line ETT adjuncts that contain hygroscopic salts that utilize differences in vapor pressure, expired moisture content, and the patient’s temperature to increase the humidity of inspired air.  Increased moisture on inspiration helps maintain alveolar moisture.  Capnography should not be positioned in-line following HME as these moisture devices can increase breathing resistance and work of respiration, as well as increase breathing apparatus dead space (especially in pediatric patients).  This may lead to potential worsening hypercapnia and respiratory acidosis.   Recommended order: endotracheal tube-capnograph-HME device (proximal to distal)

Nasogastric/Orogastric Tube:

Placement of a nasogastric (NG) or orogastric (OG) tube should be considered following intubation of a patient in order to decompress gastric contents, prevent aspiration and gastric distention.

  1. Prekker ME, Driver BE, Trent SA, et al. DEVICE Investigators and the Pragmatic Critical Care Research Group. Video versus direct laryngoscopy for tracheal intubation of critically ill adults. N Engl J Med. 2023 Aug 3;389(5):418-429