Those available ones rather concentrate on an intubator
's posture or movement than on work load of this procedure .
The likelihood of esophageal intubation increases with emergent situations, class III/IV airways (Modified Mallampati), and level of training of the intubator
. A recent review of emergency intubations performed by anesthesia trainees at a large university found difficulty in placing the ETT in 10% with a 4% complication rate.
a) Extension maneuver: pulling back of the metal handle of the ILMA towards the intubator
Intubation with FFB was done through an orally inserted William's intubator
oral airway(R) size 9 in female and size 10 in male patients.
Because the intubator
was often not present, no attempt was made to compare the measured pressure with a qualitative pressure.
However, more important than developing an ideal intubation device, would be to develop oneself into an "ideal intubator
" capable of handling any difficult airway scenario through repeated practice and proficiency with a range of available airway devices.
Several design features of a standard LMA make it possible to use as an airway intubator
: the wide bore of the LMA tube; the width and elasticity of the aperture bars; the angle at which the tube enters the bowl of the mask; and anatomic alignment of the LMA aperture with the glottis and the low pressure seal allow synchronous patient ventilation.
So, inserting an endotracheal tube through such a small opening and under such emergent circumstances, demands the most accomplished intubator
Moreover, we note that as the Discopo stylet is a rigid stylet, it may increase risk of soft-tissue damage if the intubator
uses excessive force during the procedure.
A typical example of an experienced intubator
is shown in Figure 3, with a short maximal peak associated with initial glottic exposure and a later prolonged 'plateau phase' of lower magnitude associated with intubation.
There are a number of such airways available including the Berman Intubating Airway (Vital Signs, Totowa, NJ, USA), Ovassapian Fibreoptic Intubating Airway (Kendall, Argyle, New York, NY, USA) and the Williams Airway Intubator
(Williams Airway Intubator
Ltd, Calgary, Canada) (5).
Other devices or procedural factors that hamper the insertion of the endotracheal tube over a fibrescope include the airway intubator
, cricoid pressure or jaw thrusting (19).