First clinical experience of tracheal intubation with the SensaScope®, a novel steerable semirigid video stylet Biro P , Bättig U , Henderson J , Seifert.

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Presentation transcript:

First clinical experience of tracheal intubation with the SensaScope®, a novel steerable semirigid video stylet Biro P , Bättig U , Henderson J , Seifert B British Journal of Anaesthesia Volume 97, Issue 2, Pages 255-261 (August 2006) DOI: 10.1093/bja/ael135 Copyright © 2006 British Journal of Anaesthesia Terms and Conditions

Fig 1 (a) The SensaScope® (a) before attachment of the CCD camera (b) and light cable (c). (b) The assembled system with a mounted tracheal tube ready for use. British Journal of Anaesthesia 2006 97, 255-261DOI: (10.1093/bja/ael135) Copyright © 2006 British Journal of Anaesthesia Terms and Conditions

Fig 2 Images from the two important phases during tracheal intubation with the SensaScope®. (a) Monitor view of the entire glottis while the tip of the scope is just beyond the upper teeth. (b) The carina is clearly seen on the video screen after the SensaScope® is advanced into the trachea. British Journal of Anaesthesia 2006 97, 255-261DOI: (10.1093/bja/ael135) Copyright © 2006 British Journal of Anaesthesia Terms and Conditions

Fig 3 Recommended intubation technique with the SensaScope®: 1. Left hand: Macintosh laryngoscope is passed with standard technique and positioned with the tip in the valecula. 2. Right hand: takes the SensaScope® with the tube already mounted (the most distal part of the tube tip must be facing anteriorly). The tip of the SensaScope® is kept in neutral position with the thumb. 3. Left hand: the view of the glottis is optimized. 4. Right hand: The SensaScope® is introduced in the midline. The tip is advanced 1 cm beyond the maxillary incisors and directed towards the uvula. From this point on, visual control is entirely with the video-monitor. It should be possible to see the vocal cords. 5. Right hand: the SensaScope® is advanced carefully keeping the intraoral part close to the palate. 6. As the SensaScope® is advanced, the tip is elevated by depressing the control lever with the thumb. These manoeuvres are used to keep the glottis in the middle of the video image. British Journal of Anaesthesia 2006 97, 255-261DOI: (10.1093/bja/ael135) Copyright © 2006 British Journal of Anaesthesia Terms and Conditions

Fig 4 Recommended intubation technique with the SensaScope®: 7. Right hand: the proximal end of the SensaScope® is rotated downwards as the scope is advanced into the trachea. 8. Simultaneously the tip of the SensaScope® is flexed posteriorly by moving the control lever upwards. These manoeuvres are adjusted to keep the centre of the trachea in the middle of the video image. 9. Left hand: the laryngoscope is removed and the hand is moved to hold the proximal end of the tube. 10. Right hand: the entire system is advanced towards the carina. 11. During this advancement the position of the scope tip is constantly adjusted to keep the centre of the trachea in the middle of the video image. 12. Left hand: when a good view of the carina has been achieved, the tube is advanced off the SensaScope® (firmly held with the right hand). The tip of the tube should become visible. 13. Left hand: the tip of the tube should be adjusted to a position ∼2 cm above the carina. The tube is held firmly in this position. 14. Right hand: the thumb is removed from the control lever so that the tip of the scope returns to neutral position. The SensaScope® is withdrawn carefully. British Journal of Anaesthesia 2006 97, 255-261DOI: (10.1093/bja/ael135) Copyright © 2006 British Journal of Anaesthesia Terms and Conditions

Fig 5 Learning curve based on time taken to complete intubation [mean (sd)]. Intubation in 2nd to 4th patients takes significantly less time than first (P≤0.005 after Bonferroni correction). British Journal of Anaesthesia 2006 97, 255-261DOI: (10.1093/bja/ael135) Copyright © 2006 British Journal of Anaesthesia Terms and Conditions