air-Q Reusable

Introduction

The everyday airway …
that’s ready for the unexpected ..!!!

Features

FEATURES

The new design has evolved into a superior airway and the disposable air-Q is now available in 6 sizes!

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Clinical Use

Supraglottic Masked Airways have been in the U.S. market since the early 1990’s.

• They are used as an alternative to the combination of face masks and other airway devices.
• Intubating Laryngeal Airways are inserted into the pharynx and create a low pressure seal around the laryngeal inlet in the pharynx.
• All alternative airways share the same basic principle – a tube delivers oxygen and/or gas without penetrating the vocal cords (glottis) – hence the generic name supraglottic airways.
• These airways generally have one or two cuffs that inflate in the lower pharynx to create a seal enabling oxygen (gas) delivery.
• These devices are alternatives to ET tubes that penetrate the glottis and to mask ventilation.
• Supraglottic Airways provide an effective method of forming an airway during anesthesia in patients.
• These airways are more secure than a face mask while less invasive than intubation with an ET tube.
• They are used when tracheal intubation is not necessary or during an unexpected “difficult” airway situation.
• Patients requiring controlled or assisted-ventilation receive fresh gas through the airway connector.
• The growing popularity of these devices stem from their ease-of-use, their role in the “difficult” airway and the advantages they offer over the face mask and more invasive tracheal intubation.

Advantages

• Clinicians find they are quicker and easier to insert.
• Less resistance to breathing.
• Less incidence of sore throat.
• Smaller hemodynamic and respiratory response to insertion, maintenance and removal. This allows use of lighter levels of anesthesia agents than what might otherwise be necessary.
• Lower drug costs.
• Less trauma to the vocal tract than an ET tube.
• May be used in delivery of anesthesia, resuscitation, intensive care and management of the difficult airway.
• Color-Coded – 6 disposable air-Q sizes available (1.0, 1.5, 2.0, 2.5, 3.5, 4.5).
• Can be used for most adults, pediatric and infant patients.
• Generally the 3.5 is used on small adults or female patients and the 4.5 is used on large adults or male patients.
• They are available in ½ sizes since these fit a broader range of patients.
• Reusable air-Q is available in 4 sizes (2.0, 2.5, 3.5, 4.5) but sizes 1.0 and 1.5 will be available soon.
• Designed by an anesthesiologist following 8 years of clinical research.
• Infant sizes were designed specifically for the pediatric anatomy – not just miniature versions of adult airways.
• The air-Q should be used routinely as a classic passive airway.
• The air-Q is user-friendly, placement in patients is easy and air movement is outstanding.
• It has the added benefit of allowing for intubation using standard ET tubes.
• In addition to delivering oxygen and/or gas to the patient, the patented air-Q allows clinicians to intubate through it using a standard oral endotracheal tube (OETT sizes 4.0 – 8.5).
• Allows for air-Q removal after intubation. The user can easily remove the air-Q without dislodging the ET tube with the air-Q Removal Stylet.
• Alternatively, clinicians can choose to remove the ET tube and maintain the air-Q in place as the patient emerges from anesthesia with less bucking and straining with this exit strategy method.
• Single-patient-use availability offers the convenience of a disposable product while reducing concerns over cross-contamination issues.

Guide

• Generally use size 3.5 for women and 4.5 for most men.
• Lubricate the back of air-Q and front ridges of mask cavity.
• Leave red tag on pilot balloon when inserting. After insertion, remove the red tag and add 3 – 5 cm air until firm bounce on pilot balloon is achieved.
• Use tongue depressor to lift tongue and get air-Q started.
• If the air-Q gets stuck during placement, put the left index finger behind the mask and use finger by pushing forward, to assist the mask around the corner.
• Do mandibular lift while passing air-Q into the pharynx.
• Check position of air-Q . . . patient’s incisors should be between 2 horizontal insertion marks indicated on air-Q.
• Place patient’s head in neutral position after placement.

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Intubation through air-Q

• Tape air-Q into center of maxilla prior to intubation.
• Lubricate OETT liberally and lubricate inner portion of air-Q airway tube by sliding OETT up and down within tube several times.
• Pre-load OETT to 18 cm mark for 3.5 and 20 cm mark for 4.5.
• Pass a Fiber Optic scope through OETT – should see straight shot to glottis.
• If you do not immediately see the opening to the trachea and the cords, epiglottis most likely down-folded.
• Should epiglottic down-fold occur, deflate air-Q, back out about 2 – 3 inches, perform jaw lift and reinsert.

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Blind Intubation

• Before first attempting blind intubation, look through air-Q a few times with Fiber Optic scope to see how air-Q lines up.
• On blind intubations, expect success on first pass about 60% – 70% of the time.
• If not successful, miss is usually low.
• Apply a little pressure over cricoid-thyroid area to lower inlet further into mask.

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Minimizing Leaks

• Make sure the patient’s head is in neutral position.
• Make certain jaw lift is used during insertion.
• Make certain cuff is not over-inflated – check pilot balloon, if mushy, add a little air; if hard, remove air.
• Check position of air-Q . . . patient’s incisors should be between 2 horizontal insertion marks located on the air-Q.
• With air-Q inflated, pull back 1/4 to 1/2 inch.
• Consider using different size air-Q, depending on patient, go up or down 1 size.
• If small leak, check ETCO2 waveform and inspiratory pressure – may not be a problem if there is good ETCO2 and inspiratory pressure waveform.