Airtraq - Guided video intubation

Training > Technique

Summary

Slide midline around the tongue

1. Slide midline around the tongue

Center vocal cords

2. Center vocal cords

Push ETT

3. Push ETT

Remove midline

4. Remove midline

Summary
  • Keep Midline
  • Do not insert too deep
  • Lift gently
  • Twist Airtraq to center vocal cords
  • Corkscrew ETT if needed

Holding Airtraq

Holding Airtraq
  • Use your dominant hand to facilitate insertion into patient’s mouth.
Holding Airtraq
  • Hold it with gently using your fingers rather than the full palm.
  • Do not hold like a direct laryngoscope.
Holding Airtraq
  • Hold Airtraq close to the patient’s mouth. Do not hold it from the top.

Macintosh vs Miller

Macintosh
Blade in the Vallecula (preferred)

Blade in the Vallecula (preferred)
  • Airtraq allows both techniques
  • Macintosh style is the preferred option since it requires less upward traction and therefore it is softer on patient tissues.
  • If the Airtraq is already underneath the epiglottis and the user prefers to intubate Macintosh style withdraw the Airtraq until the epiglottis falls and advance the tip of the blade into the vallecula.

Miller
Blade underneath Epiglottis

Miller Blade underneath Epiglottis

Location of glottic structures

Location of glottic structures

If vocal cords are not seen it is very likely that Airtraq has been inserted TOO DEEP, if so perform the following maneuver:

Location of glottic structures

A gent lift of the Airtraq causes the glottis to open and drops the interarytenoid notch below the middle of the image (optimal position for successful ETT insertion)

Most common pitfalls

Pushing tongue inwards

Pushing tongue inwards

Airtraq elevation too early, before tip of the blade gets to back of tongue

Airtraq not midline

Airtraq not midline

Airtraq inserted like a direct laryngoscope blade (to the left of the oropharyngeal cavity)

Airtraq inserted Too Deep

Airtraq inserted Too Deep

Airtraq inserted too close to the glottis or too posterior in front of the oesophagus

Airtraq tilted against upper teeth

Airtraq tilted against upper teeth

Airtraq tilted against upper teeth