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December 1967

Prolonged Endotracheal Intubation: In Respiratory Failure

Author Affiliations

Lackland Air Force Base, Tex

From the Pulmonary and Infectious Disease Service, Department of Medicine, Wilford Hall USAF Hospital, Aerospace Medical Division (AFSC), Lackland Air Force Base, Tex. Dr. Weg is now with the Department of Internal Medicine, Baylor University College of Medicine, Houston.

Arch Intern Med. 1967;120(6):679-686. doi:10.1001/archinte.1967.00300050035006

INITIALLY machanical assistance, and presently full control of respiration, has been accepted as fundamental in the therapy of respiratory failure. The primary requirement is a patent airway of adequate size. An oral or nasal pharyngeal airway and mouth to mouth resuscitation may be adequate for short-term assistance, but this is esthetically displeasing and on occasion may result in transmission of infection. The recent case report of cutaneous tuberculosis of the nasolabial fold, secondary to mouth to mouth resuscitation in the Bellevue Hospital emergency room, attests to this.1 The use of any of the resuscitator bags or a mechanical respirator is certainly preferable if available. These bags are nominal in cost and should be available on all wards, intensive care units, and emergency rooms. Prior to using a pharyngeal airway, the oral pharynx should be cleared of any foreign material, ie, vomitus, the head extended, and the jaw-tongue assembly pulled