air-Qsp

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The air-Q®sp Self-Pressurizing Masked Laryngeal Airway-
A Breakthrough in Supraglottic Design

…The latest addition to its Family of Airway Management Products

  • Over 15 years ago, Daniel J. Cook, M.D., researched, designed, developed, and patented the air-Q® Masked Laryngeal Airway that has gained worldwide acceptance.
  • The air-Q® Self-Pressurizing Masked Laryngeal Airway (air-Qsp) is a new product that incorporates the air-Q® design with revolutionary Self-Inflating Mask.

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INTRODUCTION


6 color-coded air-QSP Single-Patient-Use Sizes Available:
(1.0, 1.5, 2.0, 2.5, 3.5, 4.5)

  • * air-QSP is also available in a limited number of sizes for the reusable version (60 uses).
  • * Reusable infant sizes “coming soon” and you will be notified when they are available.

 

 

 

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Self-Pressurizing Masked Laryngeal Airways


No Inflation Apparature

Creates a simpler, easier design for “Everyday Use”. Removable color-coded connector provides a conduit for intubation.

 

 

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Takes the Guesswork out of Mask Cuff Inflation
ADVANTAGES

  • Creates a simpler, easier design for “Everyday Use”.
  • No Inflation Apparature
  • Removable color-coded connector provides a conduit for intubation.
  • No Inflation Line Necessary.
  • Mask Cuff inflates with Positive Pressure Ventilation.
  • Eliminates the extra step of inflating the mask.
  • Eliminates mask cuff overinflation.
  • Eliminates the extra step and guesswork of mask cuff inflation reducing potential for over inflation.
  • The patented breakthrough design allows Positive Pressure Ventilation (PPV) to self-pressurize the mask cuff. This increase in cuff seal pressure occurs at the exact time you need it, during the upstroke of ventilation.
  • On exhalation, the cuff decompresses to the level of the PEEP.
  • The intra-cuff pressure cycles between the peak airway pressure usually between 15cm-30cm H20 (This results in a safer, efficient, low-pressure seal during a case).
  • The cyclical lowering in intra-cuff pressure may assist in diminishing complications such as mucosal and nerve trauma that result from over-inflating traditional peripheral laryngeal mask cuffs.

The innovative design allows the mask cuff to breathe with the patient providing the optimal seal on inhalation.

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DESIGN OBJECTIVES (Exhalation)
Design objectives are simple and unlike any existing supraglottic airway products. On Exhalation, the cuff decompresses to the level of the PEEP. The intra-cuff pressure cycles between the Peak Airway Pressure usually between 15 – 30 cm H2O and the level of PEEP < 10 cm H2O.


DESIGN OBJECTIVES (PPV)

The new design allows Positive Pressure Ventilation to self-pressurize the mask cuff. The increase in cuff seal pressure occurs at the exact time you need it . . . during the upstroke of ventilation.


ADDITIONAL DESIGN OBJECTIVES

  • The disposable air-Qsp should be used routinely as a classic, passive airway.
  • The air-Qsp is user-friendly, placement in patients is easy and air movement is outstanding.
  • With deal pressures on inhalation consistently at or above 25cm, it is ideal as a passive and rescue airway.
  • It has the added benefit of allowing for intubation using standard ET Tubes.
  • In addition to delivering oxygen and/or gas to the patient, this patented air-Q allows clinicians to intubate through it using a standard oral endotracheal tube, (OETT sizes 4.0-8.5)
  • Allows for air-Qsp removal after intubation, the user can easily remove the air-Qsp without dislodging the ET tube with the Removal Stylet.

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FREQUENTLY ASKED QUESTIONS

How does the air-Qsp work?

  • The innovative air-QSP design incorporates a small internal opening under the heel of the balloon between the lumen of the breathing tube and mask cuff. This creates a communication between the airway tube and mask cuff.
  • When delivering Positive Pressure Ventilation (PPV), the increased airway pressure will instantaneously increase the pressure within the cuff tightening the seal.
  • When clinicians place the breathing device onto the air-QSP Color-Coded Connector, the positive ventilation pressure of squeezing the breathing device instantly augments inflation of the mask cuff creating the seal pressure needed.
  • The mask cuff pressurizes as you ventilate essentially breathing with the patient..

Can You Over-Inflate the Mask Cuff?

  • NO. Maximum cuff pressure, corresponding to the Peak Inspiratory Pressure, is in the green zone (safe zone) for cuff pressures of 15 cm – 30 cm H2O. It provides just the mask cuff seal pressure needed, when needed, as you ventilate allowing a maximum airway seal with a minimum amount of pressure.

When Patients are Spontaneously Breathing during Peak Inspiratory Pressure does the Inspiratory Breath Deplete the Air out of the Cuff?

  • NO. Testing has shown that the inspiratory breath will draw from the much larger opening of the breathing tube or path of least resistance.

Does the air-Qsp Seal as Well as a Normal Supraglottic Airway?

  • YES. Average seal pressures are consistently over 20 cm H2O. Since the air-QSP cuff pressure of the SP increases on Positive Pressure Ventilation (PPV), the highest seal pressure will occur at the PIP of 25 cm – 30 cm H2O.
  • Due to the unique air-QSP mask bowl and cuff design, this is enough pressure to create a good seal and will not over-inflate; decreasing seal pressure occurs when the cuff is over-inflated.

Is the air-Qsp Safe at Low Cuff Pressures?

  • YES. The average seal pressures needed to minimize potential aspiration is around 12 cm – 14 cm H2O.
  • The average seal pressure at atmospheric pressure, which would be the worst possible situation, is still around 17 cm H2O, well above the needed 12 cm – 14 cm.

Can you Still Intubate Through the air-Qsp?

  • YES. Just like the regular air-Q, it has a removable Color-Coded Connector. Removing the connector allows the clinician to place an OETT through the breathing tube and into the laryngeal inlet.

Will Nitrous Oxide (N2O) effect the Mask Cuff Volume?

  • NO. Since the air-QSP is an open system, (N2O) will not create an increase in the volume of the mask cuff.

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Insertion “Tips & Techniques”

  • Extend the head back.
  • Lubricate the air-Qsp mask cuff, back of the cuff and the ridges.
  • Use a tongue depressor to lift the tongue.
  • Place the air-Qsp in at a forward angle aiming for the back of the tongue and soft palette.
  • Once around the corner, take out the tongue depressor, lift the mandible and push with the index finger on the top of the colored connector.
  • Support the airway tube with your other fingers.
  • Check the placement with Positive Pressure Ventilation (PPV), listen for breath sounds and confirm with capnography.

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CLINICAL SUPPORT STUDIES

  • Pediatric Anesthesia ISSN 1155 – 5645 – 21 (2011) 673 – 680 © 2011 Blackwell Publishing Ltd.
  • Pediatric Anesthesia ISSN 1155-5645 – 22 (2012) 161 – 167 © 2011 Blackwell Publishing Ltd.
  • Prospective evaluation of the self-pressurized air-Q intubating laryngeal airway in children.
  • A randomized crossover comparison between the LMA-Unique™ device and the air-Q Intubating Laryngeal Airway in children.
  • Narasimhan Jagannathan, Lisa E. Sohn, Ravinder Mankoo, Kenneth E. Lange, Andrew G. Roth & Steven C. Hall Department of Pediatric Anesthesiology, Children’s Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Narasimhan Jagannathan, Lisa E. Sohn, Ravinder Mankoo, Kenneth E. Langen & Tessa Mandler, Children’s Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

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