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FDNY Gets Combitube

NEW YORK-- A Brooklyn woman who stopped breathing for nearly five minutes after a severe allergic reaction to seafood would probably have died Sunday had it not been for a new intubation device the fire department put into use only hours earlier, FDNY officials said yesterday.

Instead, Lucy Rosario, 24, was in critical condition yesterday at the Brookdale University Hospital and Medical Center, after medics recently trained on the device used it when they couldn t get her breathing by the traditional method of sticking a tube into the trachea and using a pump to aid breathing.

If it hadn t been for that tube, she would have died, because there was no other way for us to get air into her, said Lt. Lisa Freitag, 41, an 18-year department veteran from Richmond Hill, Queens, who was part of a three-member team that was the first to use the device. It was about a minute after we put in that tube that we got her pulse back.

The device, known as the Combitube, is the newest tool FDNY paramedics can use when someone has stopped breathing. When inserted, the tube works in two ways -- either feeding air straight into the lungs via the trachea or by sealing the esophagus, thus allowing air to flow through the trachea and into the lungs, said John Peruggia, chief of FDNY emergency medical services.

Invented in the early 1990s, the Combitube has been used by emergency medical services and fire departments for years, said Sherri Cowen, marketing manager for Covidien, which manufactures it. The FDNY began looking at the product during the summer, having come across a small number of documented cases where paramedics arriving on the scene of a cardiac arrest were having trouble intubating victims, Peruggia said. He did not give a number. The department spent about $30,000 to buy 600 devices, he said.

In October, the FDNY began training more than 675 medics in how to use the device, as part of the required one-day refresher course paramedics must take annually at the training facility in Bayside. The device was delivered to units last week and was cleared for use beginning midnight Sunday, Peruggia said.

At 2:09 p.m. Sunday, authorities got a 911 call from a hair salon in East New York that a woman with asthma was having an allergic reaction, fire officials said.

Two paramedics, William Delaney, of Mount Sinai, and Christopher Natoli, of Levittown, arrived six minutes later and tried to intubate the woman, but because of swelling and vomit, the tube would not go down, officials said.

Freitag arrived about two minutes later just as Rosario s heart stopped, and a decision was made to use the Combitube.

It was a little scary at first, because it is much larger than the other tube we use and this woman was so small, she said. But it worked like it was supposed to.

How it works

The Combitube provides paramedics options for resuscitating a person who has stopped breathing.

THROUGH TRACHEA

The preferred way to revive a victim is inserting the Combitube into the trachea, which is the air passageway to the lungs. Here, one of the balloons along the tube is inflated to create an airtight seal (1). Air then is pumped into the tube (2) and into the trachea (3) to get the victim breathing again.

THROUGH ESOPHAGUS

The trachea is hard to reach, and in many cases parademics can only insert the tube in the esophagus, where food goes. If this happens, both balloons along the tube are inflated to seal the air and digestive passageways (1). Air is pumped into the tube (2) and forced into the trachea via holes on the tube s sides (3).

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