Airtraq - Guided video intubation

Training > FAQ's

Clinical usage

What should be the head positioning prior to insertion of the AIRTRAQ?

The AIRTRAQ allows one to start with the head in the “neutral” position vs. the sniffing position or hyperextending the neck.

Where should the blade (tip) of the AIRTRAQ be located?

Typically the AIRTRAQ is placed in the valecula and above the epiglottis, like the Macintosh laryngoscope blade approach, however one can go below the epiglottis, like the Miller blade, if this gives a better exposure or view of the vocal cords.

What about use with morbidly obese patients?

The AIRTRAQ is ideal for these cases. To insert the AIRTRAQ one may have to start from the side and rotate the AIRTRAQ as it is inserted.

How do the hemodynamic changes during the use of the AIRTRAQ?

It has also been demonstrated in several clinical studies that Tracheal intubation with the Airtraq® resulted in less alterations in heart rate and arterial pressure when compared to Direct Laryngoscopy.

How do I use AIRTRAQ to perform awake intubations?

Studies have shown AIRTRAQ can facilitate awake intubations well. A camera makes the procedure much easier to perform (refs. 5, 6, 7, 8)

Can I use the AIRTRAQ to intubate a patient in the sitting position?

Yes – due to the unique design of AIRTRAQ a clinician can either view down the optical channel or use with an AIRTRAQ camera and display. Independent evidence also exists that shows AIRTRAQ is superior to both the GlideScope and LMA Fastrach during simulated face-to-face difficult tracheal intubation (ref. 11).

Should I always use a bougie with AIRTRAQ?

No: however this technique can sometimes assist in cases where the vocal cords present in a very anterior position.

My patient has a limited mouth opening – does this mean I cannot use AIRTRAQ?

There is a minimum mouth opening for each AIRTRAQ size. However, if an adult has an extremely limited mouth opening, it has been reported that a pediatric AIRTRAQ can introduce a bougie past the vocal cords and enable intubation.

If I want to exchange ET tubes can I use AIRTRAQ for this?

Yes: AIRTRAQ enables the clinician to view the complete airway quickly and clearly. Evidence also exists which shows time to secure the airway is shorter with the Airtraq amongst novice laryngoscopists (ref. 9)

Can I use AIRTRAQ for rapid sequence induction (RSI)?

Yes. Studies show that in the presence of cricoid pressure, the mean duration of intubation is markedly shorter using AIRTRAQ than using Macintosh laryngoscopy. (ref. 10)

Can I use AIRTRAQ in the MRI suite?

Prodol has received FDA 510(k) clearance for the AIRTRAQ Avant as MR Conditional (up to a Tesla 3 magnet).

Competition & routine use

Why is AIRTRAQ better than competitive devices available on the market?

  • There are no capital or maintenance costs making AIRTRAQ affordable and cost effective.
  • Since there is no capital investment AIRTRAQ can be fully deployed and be always available.
  • The channel easily guides the ET tube through the vocal cords. Stylet is not required.
  • Its anatomical design means there is no hyperextension of the neck and intubation is less traumatic.
  • AIRTRAQ offers multiple visualization options (WiFi Camera, Smartphone Adapter and Connection to endo Cams). Direct View is always integrated as a back up.
  • Simple to use and easy to learn.
  • AIRTRAQ is portable.
  • AIRTRAQ SP ‘All-In-One’ design means it is ready to use with no set up.
  • The disposable design prevents the need to clean and reprocess between uses addressing cross-infection concerns.

Why should I use AIRTRAQ AVANT for routine use?

Airtraq Avant´s minimum cost per use makes it feasible to perform video laryngoscopy for routine use, not just difficult airway cases.

Device characteristics

Is there a warm-up or start-up period?

Typical warm-up time is 30 seconds.. Switch on & wait until the light has stopped blinking before insertion.

However, for emergency cases, where patients are not spontaneously breathing, AIRTRAQ can be used without waiting.

How do I select the size of AIRTRAQ

Refer to the minimum mouth opening and size of ET tube required in the instructions for use:

How does the Airtraq Avant compare in both size and weight to other products?

AIRTRAQ SP Adult Regular is 16 mm thick & AVANT 17 mm thick compared to Macintosh at 17.5mm. The AIRTRAQ SP and AVANT Adult Regular models both weigh less than a standard ISO blade and handle by over 300 grams. With a WiFi camera attached to the AIRTRAQ models, they still weight less than a standard ISO blade by over 100 grams.

Can I reuse either the AIRTRAQ SP or the AIRTRAQ AVANT?

No: the AIRTRAQ SP and AIRTRAQ AVANT BLADE are single patient use devices.

**** Warning! Cleaning and reuse of the AIRTRAQ AVANT BLADE and/or AIRTRAQ SP may compromise patient safety ****

The AIRTRAQ AVANT optics are designed to be used 50 times and instructions for disinfection can be found in the Indications for Use

Does the AIRTRAQ require a special ETT?

No: any make of ETT can be used. Note the outer diameters of some ET Tubes are different and may affect the fit in the guide channel.

What is the service life of AIRTRAQ AVANT OPTICS?

50 intubations: a service life is counted when the OPTIC anti-fogging element has reached operating temperature.

What is the shelf-life of the packaged product?

THREE (3) years.

Is there a possibility of tearing the ET tube cuff?

If the ET tube is not properly lubricated and it is repeatedly advanced past the distal end of the channel guide and then pulled back into the channel the cuff could tear. Withdrawal of the ETT while in the guide channel should be done carefully.

How can I avoid interference affecting the AWDR display image when using the camera?

Remove the source of interference. Select another channel on both the display & the camera or connect the camera to the AWDR directly with the supplied cable.

Does the AIRTRAQ have FDA 510(k) clearance?

Yes, K121378.

Tips & techniques

What is the most likely usage error for initial Airtraq users?

The most common mistake is to insert the Airtraq “TOO DEEP” into the larynx or you have NOT GENTLY LIFTED the Airtraq

Inserting too deep provides a view of the vocal cords and arytenoids, with the “center” of the view being the arytenoids rather than the vocal cords. In this case the ET tube may “hit” the arytenoids and not go through the vocal cords. To correct, simply withdraw the AIRTRAQ and / or gently lift up, this should place the vocal cords in the “center” of the view and make ET tube insertion easy.

How do I avoid the tongue being pushed inward?

It is recommended that that the AIRTRAQ is not lifted too early to the vertical position when placing into the airway, but slid around the tongue first. A small amount of water soluble lubricant applied onto the blade of the AIRTRAQ may also assist insertion.

I advance the ETT and it hits the epiglottis, what should I do? Rotate the ETT slightly counter clockwise whilst advancing, this will centralize the tube below the epiglottis.

I see the vocal cords and airway structures but cannot advance the ETT through the cords?

Usually in this example the vocal cords are not in the “center” of the view, but in the upper portion of the view. BACK OUT the Airtraq and LIFT it to change the view. One may have to rotate, clockwise or counter wise the AIRTAQ as well.

What about secretions?

The AIRTRAQ is not generally affected by secretions; however, excessive blood or secretion might obscure the optics and view. In these cases you can use suction before insertion. One can also remove the Airtraq and rinse the distal tip in saline, then reinsert

The ET tube feels tight in the channel guide so is there anything I can do?

Ensure the correct size of ET tube is being used and is well lubricated. When advancing the ET tube tilt the proximal end of the ET tube towards you and this will aid advancement. Note some ET Tube have larger outer diameters and may fit snuggly in the guide channel. In this case either change to a smaller ET tube or use the next larger size Airtraq.

Are there any other techniques of introducing the AIRTRAQ into the airway?

Yes: it may be preferable to introduce the AIRTRAQ like a Guedel Airway with some patients (short neck, obese). This enables the AIRTRAQ to be rotated as it is advanced into position. The AIRTRAQ can also be introduced into the airway via the side of the mouth and then centralized as it is advanced.

Training & experiences

Is there a learning curve for the AIRTRAQ?

Yes: between 5 to 10 uses helps most clinicians to become comfortable with the AIRTRAQ.

What are the clinical experiences for AIRTRAQ?

The AIRTRAQ has been successfully used in more than 1 million intubations for routine, difficult, and complex airways.

What clinical studies are available for AIRTRAQ?

Many studies have been published. Check clinical Studies Section of this web site for the latest information.

I want to teach airway management using a manikin – do you have a training AIRTRAQ version for non-clinical teaching use?

Yes – please contact your local AIRTRAQ distributor.