This month we continue our look at trends spotted at the ACEP Scientific Assembly held last October. This month we’ll look at a trend that has been slowly gaining momentum over the past several years: fiber-optic airway management. Fiber-optics are slowly moving from the realm of anesthesiology and the OR to being the new standard of care in emergency medicine. The fiber-optic evolution continued at ACEP with a couple of new products as well as improvements on many others.
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AirTraq by King Systems
The Gist: The AirTraq has been around for a few years now as a poor-man’s fiber-optic substitute. It is a great option for EMS systems as well as smaller volume EDs as it is completely disposable and relatively affordable. The AirTraq uses a prism as a substitute for fiber-optics. King Systems improves on this device by adding a video-system to clip onto the scope allowing multiple people to observe - as well as record - the intubation.
ETA: Currently Available www.kingsystems.com
BRS-5000 Flexible Bronchoscope by Vision Sciences
The Gist: The BRS-5000 is a take on standard flexible bronchoscopes with a slight twist. The scope itself is encased within a plastic sheath that also contains the suction port. This allows for continued use of the bronch without the need to send it out for sterile processing. This may sound like a minor issue but if you are in a department with one bronch and no overnight processing it can literally be the difference between life or death for a patient. Another benefit of not having to rely on sterile processing is that you do not have to worry about them “misplacing” your bronch. After losing a $12,000 bronch to sterile processing a few years ago (I’m pretty sure I saw it on Ebay later that week) I always get a queasy feeling when I see my bronch walk off in a stranger’s hands. Optics on the BRS-5000 are adequate and the system comes with its own LCD screen. Vision Sciences also offers an NP scope.
ETA: Currently Available www.visionsciences.com
Video RIFL by AI Medical Devices
The Gist: The Air RIFL has been around for a few years now. For those not familiar with it, it is a rigid fiber-optic intubating scope similar to the Bonfils or Levitan scopes with the exception that the tip can be manipulated by squeezing a lever at the handle facilitating intubation on anterior airways. The Video RIFL now improves on this by adding an LCD screen where once there was just an eyepiece. The LCD screen allows for multiple viewers and recording. The tip also features an LED light-source which decreases fogging over standard bulbs.
ETA: Available January 2009 www.aimedicaldevices.com
C-MAC by Storz
The Gist: The C-MAC is Storz’ answer to the Glidescope. It takes their previous fiber-optic mac model and condenses it to a small case and IV pole. The C-MAC has the shape of a standard Mac blade with a small LCD screen attached via a single cable. This new model allows for multiple people to view and record the airway but also allows the operator to directly record intubation with the simple push of a button in the handle of the blade. Prior systems required external recording devices and large carts to achieve the same capabilities.
ETA: Available when you read this but expect backorders www.karstorz.com