Archive September 2014 XV, No. 9

Video Views of Airway Visualization Devices

What can we learn from online outlooks?

David Bernard, Senior Associate Editor

BIO

Video-assisted laryngoscopy has revolutionized airway management. While anesthesia providers warn that the technology cannot replace the skill and training necessary to intubate a surgical patient, they admit that the ability to see “around the corner” of respiratory anatomy gives them an advantage in challenging airway situations. We asked a panel of anesthesiologists what they saw when reviewing a selection of videolaryngoscope demonstrations online, and we’ve included links to the videos they watched. Here’s what stood out to them.

— David Bernard

The Commentators

  • Carlos Brun, MD, is an anesthesiologist and medical-surgical ICU co-director at the VA Palo Alto Health Care System in California.
  • Gary Lawson, MD, provides anesthesia at the Adult & Children’s Surgery Center of Southwest Florida in Fort Myers.
  • David Rosen, MD, is the president of Midwest Anesthesia Partners in Naperville, Ill.
  • Ashish Sinha, MD, PhD, is vice chair of Anesthesiology and Perioperative medicine at Drexel University College of Medicine in Philadelphia, Pa.

The Devices

Airtraq Avant
tinyurl.com/kovmtmm

Airtraq Avant

The pitch: Reusable battery-powered optics completely enclosed in a single-use, rigid plastic blade.

Dr. Brun: An optional wireless display eliminates bulk, but still allows simultaneous video and eyepiece use, which may be valuable for beginning instruction.

Dr. Rosen: A simple lightweight device, but it is big in the mouth: possible dental trauma.

Dr. Lawson: For obese patients with lots of soft tissue and a big tongue, this isn’t a good design.

Dr. Sinha: The fact that it’s disposable is an advantage and a disadvantage. When you reach for it, you know that it’s sterile. But there’s an amount of social guilt over medical waste.

Clarus Video System
tinyurl.com/lgq2scy

Clarus Video System

The pitch: A malleable stylet outfitted with an LED light source, camera and display screen.

Dr. Rosen: It’s good for small mouth openings or wired jaws. It can snake through anything. When all else fails, it’ll save the day.

Dr. Lawson: The optics section is rigid. Note that the camera end doesn’t extend beyond the endotracheal tube, so it’s not maneuverable.

Dr. Sinha: The long length (31.7 cm) is a challenge for people who aren’t very tall. But the advantage of looking right through the endotracheal tube is, you know exactly where you’re driving.

Dr. Brun: The system requires approximately 1 minute of defogging time prior to use.

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