AirTraq Laryngoscope

[PoPo908]

Was wondering if there has been any use of this device in the SF community - if so, I'd enjoy reading a review.

Thanks in advance.

http://www.airtraq.com

[Sdiver]

That's pretty cool.

From the Civie side, I can't see it being used all that much, in a pre-hospital setting, just because of the cost, seeing that the blades are a one shot deal. They can't be cleaned as like the "standard" blades. I would think the cost alone, would be a big deciding factor. (Hell, at my dept., we're still waiting for the EZ-IOs to come in. )

Although, I can see flight nurses/medics would find a big advantage in using it. In the cramped quarters of a helo/plane, and the ability to hook up the camera, for easier viewing, would be a big boon for them.

[Surgicalcric]

Its a really interesting instrument and I can see it being in the OR or ER where they have the means to have several handy, I cant really see it being used in either a field EMS setting, in flight, or in tactical/combat medicine (not that I am the authority on this area).

FWIW, there was a similar device being tested a few years ago (cant remember the name of it). It looked and worked on a similar principle. It was great in the OR but had a problem with saliva and vomit blurring the the fiber optics and lens, at which point it just becomes a large OPA. As well I didnt see any video in the testimonials featuring airway obstruction from saliva, food, vomit, foreign bodies, etc which are commonly encountered outside of the ER/OR with intubations.

There are other choices for those difficult intubations which dont require us carrying a single use item that takes up more space in an already over filled aid/ALS bag...

Just my .02 YMMV

Crip

[adal]

Had one for review at my ground job. Didn't like it. The light isn't very bright, the optics can get blocked by emesis and blood, and it didn't appear to have any magnification. In fact it seemed like it made the cords smaller. IMO if you are going to have a tool to assist in a critical skill you should make it better for the operator. It felt really cheap too. Didn't get to look into the cost factor at all. Just my .02. adal

[theditchdoctor]

I also wasn't impressed with the AirTraq. To be quite honest, if you are going to be working in a light sensitive (I believe that is the correct term) environment then you would be better off developing skills at digital or manual intubation or through the use of a non-visualized airway such as a laryngeal mask airway or Combitube. Feel free to PM me if you have any further questions or want sources for information on these techniques or devices.

[docbuxton]

The OEMS program talked about it and let us play with them. Very expensive and it was said that the light only lasts for about 5-6 min and goes dead.

doc B

[Black Knight]

I would have to agree with the ditch doctor, the tactical environment is not necessarily the place for such a tool. Manual/digital intubation has been proven effective, but it also poses some challenges. Recently I began carrying the King LTD in my pack and have yet had the opportunity to use it in the field. The LTD is so easy to use (training), and it could hold you off until you can gain access to a safer location. I will try to provide a couple of links. Any input from someone who has actually used this would be appreciated. It would appear that both are made by the same company.


BK

http://www.aemj.org/cgi/content/abst.../5_suppl_1/162

http://www.kingsystems.com/PRODUCTS/...8/Default.aspx

[swatsurgeon]

The significant issue is actually not which intubation set to use but what tool or technique best fits the situation to maintain ventilation and oxygenation.
If the patient is breathing at all, a nasal airway can promote improved gas exchange spontaneously or provide the better conduit for air into the posterior naso/oro-pharynx. The tongue is no longer an issue as it is with an oral airway (IMHO, they belong ONLY in an operating room). Remember, any procedure done ties you to the patient at very close range. What is the dislodgement risk to your intended procedure? An LMA type tool or endotracheal tool has the most chances of movement and getting air into the wrong oriface. A cric or trach (surgical airway) has the least chance of moving out of the correct position and into the esophagus. I can cric or trach someone as fast as I can intubate them.....no ego here, just many hundreds of practices. As with shooting, it is a perishable skill and one you must hone to be the best possible inorder to do the best for the patient.
I am always amused by conversations from pre-hospital/field providers always looking for the next best/latest and greatest/ newest/fanciest/coolest airway technique or tool when we actually just need to spend more time refining skills with what we already have available to us. I have cric'ed and trached in the field, I have intubated in the field with anything available.....just do the job.
Be maximally proficient with a laryngoscope (I like the SF version from North American Rescue Products....light weight!!) a cric set or trach set and give up the rest of the search for the holy airway grail.
Practice and thinking saves lives, gadgets rarely do....just my 2 cents.

ss

[Black Knight]

Thanks for the advice SS. I'll be sure to throw it (King LTD) away asap! J/k

I agree there is never enough weight placed on proficiency. The fact remains that I would carry an Iron lung if it would save the life of one of my officers. Hopefully it will not come to that, those things are heavy!

I have had to perform a couple of crics in my career, and they do not bother me. Not sure how easy they'd be in the dark though. I currently carry a cric and ET kit in my bag, and I keep two NPA's in my vest for "immediate" treatment. It is only recently that I've been issued the "King" by my SWAT Medical Director. Verdict is still out until I have to use it, or until I hear poor reviews from credible sources.

SS - "Be maximally proficient with a laryngoscope (I like the SF version from North American Rescue Products....light weight!!"

I have thought about switching to it from a traditional handle. Do you have rigidity problems with the NARP handle? I've heard some concerns regarding this.

Thanks again for the advice,
BK

[swatsurgeon]

SS - "Be maximally proficient with a laryngoscope (I like the SF version from North American Rescue Products....light weight!!"

I have thought about switching to it from a traditional handle. Do you have rigidity problems with the NARP handle? I've heard some concerns regarding this.
Black Knight,
I brought mine into the O.R. and let the heavy handed anesthesiologists use it. Also used it in the Trauma bay under less than perfect conditions and it worked as well as the metal ones. The fiberglass blades held up fine and the connection from handle to blade never looked 'stressed'. The only (?) bad issue is that if the pocket clip breaks off the pelican light, it will slip out of the larygoscope handle (tube). That is the main friction contact point to keep it in the handle...I learned that one the hard way.........
ss