To the Editor:—A device called a Foregger-Racine adapter (Figure 1) recently assisted me in ventilating the lungs of a 3-yr-old child undergoing a tracheal reconstruction for subglottic stenosis. The otolaryngologist unintentionally broke the plastic adapter from the Mallinckrodt 4.5 endotracheal tube (Figure 2) we were using to ventilate the lungs and stent open the trachea. The endotracheal tube was sutured into the trachea such that it could not be easily removed. The dilemma was how to ventilate the lungs of this patient. While searching for a smaller endotracheal tube adapter to fit into the connector remnant. I was given a pediatric-sized Racine adapter by a certified registered nurse anesthetist who had carried it for more than 20 yr. The Racine adapter easily fit onto the broken endotracheal tube (Figure 3) and to the breathing circuit. The adapter contains a diaphragm with a hole through which the endotracheal tube is inserted for a secure and airtight fit that does not compromise the lumen of the endotracheal tube. The adapter, made of aluminum and silicone rubber, is a right angle and weighs 0.5 ounce. End-tidal carbon dioxide monitoring was accomplished with a straight connector attached to the Racine adapter.
Sandra Lowe, M.D., Assistant Professor, Departments of Pediatrics and Anesthesiology, Children's Hospital of Vanderbilt, T-0118 Medical Center North, Nashville, Tennessee 37232–2591.
(Accepted for publication November 28, 1994.)