Tracheal tube positioning in infants and children using the Draeger Apollo ventilator

tube and oropharyngeal (Guedel) airways are use to prevent it (1). Oropharyngeal airways are important components of intubation equipment, and one of the main functions is to prevent biting of endotracheal tube by teeth or gingiva during general anesthesia. They are made of hard plastic and cause a higher incidence of edema of lips and tongue; bleeding, hoarseness, and sore throat (2–4) Compression of the base of the tongue from the oropharyngeal airway results in ischemia and venous congestion were the causes of macroglossia and ischemic myonecroses of the muscles of the tongue (5). These complications become more dangerous in pediatric patients. We recommend the creation of airways (bite blocks) from wad of gauze swabs rolled into a cylindrical shape, placed between the incisor teeth (Figures 1 and 2). They are furthermore, suitable in endotrachealy intubated intensive care patients. The additional advantages of this airway are no damage of surrounding tissue, soak up the secretions collected in oral cavity, inexpensive, for single use, and easy to make. The only complication is the eventual misplace of pad within the oral cavity and cause airway obstruction during recovery from anesthesia. Taping the bite-block in endotracheal tube would eliminate this potential problem. The bite blocks are used in many centers, but the adoption of this practice, especially in pediatric patients, would minimize unnecessary complications after anesthesia. Antigona Hasani Department of Anesthesiology and Intensive Care, University Clinical Centre of Kosova, Prishtina, Kosova (email: antigona.hasani@gmail.com)