The following was encountered while intubating a 50 year old male with a history of neck radiation for the treatment of esophageal cancer and resection of his epiglottis and tongue base. The patient was 20 hours NPO and denied any history suggestive of active esophageal pathology.
[[[[[NEED TO ADD VIDEO]]]]]
We optimized airway positioning with external laryngeal manipulation and placed an endotracheal tube over a gum bougie and continued to the patient’s unrelated orthopedic fixation.
We induced a healthy 45 year old female for cholecystectomy for a history a biliary colic. The patient had an unremarkable airway exam and denied any abnormal ENT symptomatology. After induction the junior resident mentioned “confusing” anatomy on direct laryngoscopy; we performed video laryngoscopy to investigate producing the following images:
We obtained an intraoperative ENT consult and they suspected that it was a lipoma. Since the lesion would not compromise the airway, the ENT team elected to perform a biopsy at a later date so that the patient could be properly consented for the procedure.
The patient was seen in ENT clinic the following week and a surgical excision was performed the following month uneventfully. Pathologic examination confirmed it to be a lipoma as expected.
The oridion and nellcor portable capnometers are valuable tools offered by Medtronic for continuous etCO2 monitoring outside the OR. I frequently bring the handheld device with me to floor intubations and codes allowing for rapid troubleshooting of ETT placement and monitoring of effective chest compressions.
At the time of this writing there appears to be an abundance of AS-IS devices available on eBay for minimal cost; the majority of the devices do not come with the power cable. I was betting that these items were sold AS-IS because the device uses an unusual RJ-45 (Ethernet) based charging cable and the sellers did not want to invest $200+ on a new cable from Medtronic to test the devices.
I purchased a lot of 3 Oridion Microcaps sold “AS-IS for parts only” from eBay for $75.00.
Since we have a couple of the Nellcor devices at our institution I was able to use the OEM power brick as a reference. The brick has all the necessary info to produce a similar device:
I purchased the following power supply from amazon and wired up a rough adapter following the wiring diagram on the OEM power supply:
The result? All three Microcaps are fully functional. The last component was to produce a more finished product:
Items used for this project: – Universal DC adapter. – Female 2.1mm x 5.5mm connector Amazon item listed as an example, however, I purchased mine off eBay for $1 (if you don’t mind waiting 1-2 months). – Ethernet Cable You likely have one of these sitting around, unused. – Electrical Tape or wire heat shrink for a nicer appearing repair. – Wire stripper.