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Use of the Airtraq ® laryngoscope for anticipated difficult laryngoscopy
Author(s) -
Norman A.,
Date A.
Publication year - 2007
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2007.05075_12.x
Subject(s) - medicine , laryngoscopy , intubation , tracheal intubation , larynx , tracheal tube , surgery , cuff , anesthesia
characteristics of the syringes with excessive or variable friction of the plunger in the syringe barrel. Similar complaints regarding plunger friction have been expressed by surgical and rheumatological colleagues during joint injections and tissue infiltration. Several more serious failures were also reported. There were 35 reports of breakage of the syringe nozzle which had occurred during injection of drugs including vasopressor agents and during inflation of cuffs of airway devices. There were 29 reports of reflux of drug within the syringe around the plunger. On one occasion this was during injection of suxamethonium for rapid sequence intubation. Reflux had also occurred several times during injection of propofol, sometimes with loss of a substantial portion of the dose. On 12 occasions a syringe simply stuck; on one occasion this nearly resulted in the re-siting of an epidural because it was initially thought that the epidural catheter was blocked. These reports appear to confirm an initial impression that the poor handling characteristics of this product have caused problems in anaesthetic practice, with the potential to put patients at risk. Although the reports of serious failures constitute only a small proportion of total syringe uses, several colleagues commented that the overall performance of these syringes regularly interferes with their clinical practice. They also commented that they have not experienced these shortcomings with other makes of syringes, though we have no comparative data to confirm or deny this. These syringes are considered by several colleagues to be particularly unsuitable for use in specific areas of anaesthetic practice, for example when needing to draw up and inject drugs in emergency situations, for giving accurate doses to small children, for titration of small volumes, and in placement of nerve blocks. The manufacturers are aware of our concerns. As a result, the nozzle was strengthened in 2005, although nozzle breakage has continued to occur. We understand that the company is continuing to develop their product. We have been assured that we are the only organisation to have reported problems with these syringes, but this surprises us. It has not been possible to identify other sites using this product outside our immediate locality.