An alternative to endotracheal intubation is the use of an esophageal gastric tube airway (EGTA). An EGTA consists of an inflatable mask and an esophageal tube. The face mask has two ports: one for ventilation and one for the introduction of medications and stomach-suctioning tubes. The EGTA requires no special equipment to place, save the tube itself. The EGTA will be placed into the esophagus, its cuff inflated, and the mask secured to the patient's face.

Position the patient's head as you would for the endotracheal intubation. In order to insert the EGTA you must grasp the patient's lower jaw and tongue between the thumb and forefinger of one hand, and lift the jaw slightly. With the EGTA in the other hand, insert the tube into the mouth. Push the tube forward. The EGTA will follow the natural curvature of the region and should slide directly into the esophagus. Advance the tube until the mask sits firmly on the patient's face.

Once the EGTA is positioned, ventilate the patient (using the correct port) and check for signs that the tube is properly placed (see the discussion above). If you see the chest rise and hear breath sounds, inflate the cuff. If you do not, withdraw the EGTA and reposition the tube. As with the endotracheal intubation, you should administer a few ventilations to the patient using a mask and Ambu bag before beginning again. Tape the tube into place once it is correctly positioned.

The oxygen hose should be connected to the airway port as quickly as possible; ventilate with the Ambu bag until oxygen is available.

A suction tube may be passed through the esophageal port, should the patient vomit or if there is gastric bleeding. Any attempts to suction secretions should be limited to 15 seconds, to avoid lengthy interruptions in ventilation.

The esophageal gastric tube airway consists of an inflatable face mask and an esophageal tube. The transparent face mask has two ports: a lower port for insertion of an esophageal tube, and an upper port for ventilation. The inside of the mask is soft and pliable; it molds to the patient's face and makes a tight seal, preventing air loss.

The proximal end of the esophageal tube has a one-way, nonrefluxing valve that blocks the esophagus. This valve prevents air from entering the stomach, thus reducing the risk of abdominal distention and aspiration. The distal end of the tube has an inflatable cuff which rests in the esophagus just below the tracheal bifurcation, preventing pressure on the non-cartilagenous back of the tracheal wall.

During ventilation, air is blown into the upper port of the mask, and, with the esophagus blocked, enters the trachea and lungs. (See left illustration below.)

A gastric tube can be used to suction stomach contents before extubation. It is inserted through the masks lower port into the esophageal tube, then through a small hole in the end of the tube.
The esophageal obturator airway consists of an adjustable, inflatable face mask with a single port, attached by a snap lock to a blind esophageal tube.

When properly inflated, the transparent mask prevents air from escaping through the nose and mouth. (See right illustration below.)

The esophageal tube has sixteen holes at its proximal end through which air or oxygen, blown into the port of the mask, is transferred to the trachea. The tubes distal end is closed and circled by an inflatable cuff. When the cuff is inflated, it occludes the esophagus, preventing air from entering the stomach and acting as a barrier against vomitus and involuntary aspiration.