Inflate the pharyngeal cuff with the volume of air marked on the blue port (100 mL for the ECT, 85 mL for the ECT SA, or 80 mL for the EzT). If it does not advance easily, redirect it and then reinsert the device. Do not insert the device forcefully as significant injury can occur. Advance it in a downward curved motion until the patient's teeth or alveolar ridge lies between the two printed bands of the ETC ( Figure 20-5B) or the black stripe of the EzT ( Figure 20-6). Insert the device into the midline of the patient's mouth. The curve of the device should be in the same direction as the natural curve of the pharynx. Remove any dental devices and foreign bodies. Depress the tongue and open the jaw simultaneously. Place the nondominant fingers under the chin. Insert the thumb of the nondominant hand into the patient's mouth and over their tongue ( Figure 20-5A). 8 These attributes make these devices suitable for rescuers of all skill levels. The proximal balloon can functionally tamponade oropharyngeal bleeding and serve to minimize the risk of aspirating oral debris.

6 The balloons firmly secure the device, making dislodgment unlikely. This allows for the passage of a suction catheter, fiberoptic scope, or endotracheal tube changer (maximum diameter 3.99 mm) into the trachea. The proximal lumen of the EzT is an open lumen rather than perforations as in the ECT. When placed in the esophagus, the distal lumen of both allow for gastric suctioning. The dual lumens and balloons also offer certain advantages. They are easily inserted with patient's head and neck in a neutral position. A patient can be ventilated with the tip positioned in either the esophagus or the trachea. Both are effective as either a primary or backup airway management device. Several attributes specific to these devices contribute to their usefulness in the acute setting.

Double lumen tube