To the Editor.—
In reference to the article by Auerbach and Geehr1 entitled "Inadequate Oxygenation and Ventilation Using the Esophageal Gastric Tube Airway in the Prehospital Setting," I agree with the authors' conclusion that the esophageal gastric tube airway (EGTA) is not comparable with endotracheal intubation for airway management. The EGTA system is basically a variant of mask ventilation. The only really significant advantage of the EGTA over mask ventilation is the occlusion of the esophagus to reduce the risk of aspiration. The major factor in adequate airway maintenance with both these techniques is mask fit. This can be difficult to manage in the prehospital, emergency setting—especially by one person. The problem is magnified with the use of a handtriggered resuscitator with a mask system where the rescuer cannot feel the compliance of the patient's lungs to help in assessing adequacy of ventilation.As one who teaches mask airway
Mangold JV. Use of Esophageal Gastric Tube Airway. JAMA. 1984;252(2):208–209. doi:10.1001/jama.1984.03350020018011
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