In response to a comment mentioning Blakemore tubes on my post
about what surgery was like in the 1970s, I said they were instruments of the
devil.
This sparked the interest of surgeon who works in a rural
hospital with minimal endoscopy services. He emailed me and asked if I thought
he should have Blakemore tubes available for use because he might have to
transfer a patient with bleeding esophageal varices over a long distance for
definitive treatment.
He trained in the early 21st century and admitted that he
did not remember ever having seen a Blakemore tube. He wondered why I didn't
like it.
I have witnessed all of its major complications such as tube
dislodgement, necrosis of the nose and lips, aspiration, esophageal
perforation, airway occlusion and death.
Without any hands-on experience, he probably
should not try to use the device. In addition, the average nurse would likely
also not be familiar with caring for a patient with the tube.
On the other hand, maybe as a last resort he could try it.
I had planned to write a post about the Blakemore tube, its
insertion, maintenance and complications. But while researching it, I found
that others had done so, and better than I.
Read this excellent article on
Medscape. Registration is required, but it is free. It covers everything you
need to know about Blakemore tubes.
And here is a link to a nice video from the Yale GI
service that demonstrates the steps required to safely insert and manage them.
What do you think? After reading the Medscape piece and
watching the video, should this rural surgeon, who has never
personally seen a Blakemore tube, use it ?
