Other tubes (such as the Bivona Fome-Cuf tube) are designed specifically for use in laser surgery in and around the airway. Methods to confirm tube placement
No single method for confirming tracheal tube placement has been shown to be 100% reliable. Accordingly, the use of multiple methods for confirmation of correct tube placement is now widely considered to be the standard of care. Such methods include direct visualization as the tip of the tube passes through the glottis, or indirect visualization of the tracheal tube within the trachea using a device such as a bronchoscope. With a properly positioned tracheal tube, equal bilateral breath sounds will be heard upon listening to the chest with a stethoscope, and no sound upon listening to the area over the stomach. Equal bilateral rise and fall of the chest wall will be evident with ventilatory excursions. A small amount of water vapor will also be evident within the lumen of the tube with each exhalation and there will be no gastric contents in the tracheal tube at any time.Ideally, at least one of the methods utilized for confirming tracheal tube placement will be a measuring instrument. Waveform capnography has emerged as the gold standard for the confirmation of tube placement within the trachea. Other methods relying on instruments include the use of a colorimetric end-tidal carbon dioxide detector, a self-inflating esophageal bulb, or an esophageal detection device.
Reactive perforating collagenosis is a rare, familial, nonpuritic skin disorder characterized by papules that grow in a diameter of 4 to 6mm and develop a central area of umbilication to which keratinous material is lodged. The cause of reactive perforating collagenosis is unknown. Clinical Features
Inherited form
Keratotic papules measuring 1 to 6 mm develop on the extensor surface of the hands, the elbows, and the knees following superficial trauma. These lesions are painless. They appear as pin-sized lesions that grow to a papule of about 6mm in the following 3–5 weeks. They undergo spontaneous resolution in about 6–8 weeks leaving residual scarring. Lesions may recur throughout life. Cold weather is one of the factors known to trigger recurrences. Acquired form
In this form, keratotic papules develop on the trunk and extremities. These are commonly associated with pruritus. Lesions may or may not be related to superficial trauma. See also
Elastosis perforans serpiginosa
List of cutaneous conditions

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