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The Airtraq Optical Laryngoscope in Helicopter Emergency Medical Services: A Pilot Trial

AirTraq Avant and wireless monitor system being demonstrated by Dr DuCanto

 

 

Hi folks ! Journal reading time again!

IN the latest Air Medical Journal March 2013, this interesting but not surprising study of the use of the AirTraq Optical laryngoscope by an American civilian HEMS/air ambulance service.

The Airtraq Optical Laryngoscope in Helicopter Emergency Medical Services: A Pilot Trial

 

This is the second study looking at use of the AirTraq in a helicopter ambulance service. Cliff Reid wrote a blog article about the first Austrian study here

PREHOSPITAL AIRTRAQ USE OFTEN FAILED

 

Take home messages :

  1. Be wary of new airway devices in the prehospital setting
  2. It probably requires more than minimum period of training on mannikins before prehospital providers get confident and competent in new airway devices.
  3. The Airtraq can be not uncommonly defeated by blood, vomit and fluids in the airway.
3 Comments Post a comment
  1. I understand that the British army have a good success with AirTraq..presumably a fair share of trauma and soiled airways in their population (Bastion)…was chat about this in 2011/12 on Doctors.net.uk

    Anyone with first hand experience able to comment?

    March 7, 2013
    • it could well have but nothing published as far as I am aware. I think it all comes down to the training. If you train well enough with it, I am sure it does very well. The HEMS studies I think suffer from the minimal training given to the providers. Its pretty obvious now that indirect laryngoscopes have distinctly different learning curves. Target aqcuisition is a shorter steeper learning curve with indirect devices cw DL. Tube delivery and passage is in fact a much longer and flatter learning curve with something like the Airtraq and Glidescope. You in fact need to focus more training on tube passage and delivery. And when blood and vomit in airway, thats another learning curve to negotiate and most training does not cover that because the mannikins do not realistically simulate that scenario..you need to fill up the gastric bag and oesophagus of your mannikin with litres of sim blood and either push on the stomach area during intubation practice to simulate massive regurg of blood..or even better, connect your BVM to the oesiophagus tube and manually blow blood up into the oropharynx.
      When I have tested the Airtraq in that setting, it does very poorly. Its even hard to wipe the blood from the distal light channel aperture

      March 7, 2013
  2. Jimmy D #

    Hi guys.

    The plastic over-shoe of the Avant may change the game here a bit. But it’s also important to note that devices such as the Airtraq, Pentax, and that new laptop-video scope require a maneuver to place these devices that sweep them through the posterior pharynx in an arc that collects the nasty goo of blood and vomit (that tidbit from Seth Manoach, a former ED practitioner in NYC, and a contemporary of Scott Weingart).

    The flat plastic window doesn’t seem to accumulate goo, but we’ll have to set up a simulation to see what happens.

    March 16, 2013

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