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.
- * 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.
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.
- 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.
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.
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.
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.
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, Childrens Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Narasimhan Jagannathan, Lisa E. Sohn, Ravinder Mankoo, Kenneth E. Langen & Tessa Mandler, Childrens Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.