Becker's ASC Review

Executive Brief: Advances in Airway Management for an ASC located off-site from a tertiary hospital. Certainly if we can improve our prediction tools, which currently don't always predict difficult airways right away, we can safely manage an even broader patient population in the ASC." 8. Reducing the need for airway management. Increasing use of regional anesthesia in ASCs is reducing the need for airway management. 63 "The biggest trend in airway management for outpatient cases today is not to have to do it," says Dr. Galgon. "With the expansion of ultrasound guidance for regional anesthesia, more providers are becoming comfortable performing peripheral nerve blocks for surgical anesthesia. In these cases, we can avoid having to manipulate the patient's airway altogether. That being said, however, the need for airway management in the ASC won't ever totally go away and having appropriate airway management equipment available remains vital." n 5 Advantages of Video Laryngoscopy in ASCs By Laura Miller H ere are five advantages of video laryngoscopy ("VL") in ambulatory surgery centers from Felipe Urdaneta, MD, an anesthesiologist in Gainesville, Fla., and Richard E. Galgon, MD, MS, Assistant Professor in the Department of Anesthesiology at the University of Wisconsin School of Medicine and Public Health in Madison. 1. Increased patient base. Since video laryngoscopy systems allow for easier intubation in more complicated cases, ambulatory surgery centers can increase their patient base. "The use and availability of these technologies is expanding rapidly, and they are easy for anesthesia providers to accept fairly quickly," says Dr. Galgon. "They allow us to safely management more patients, such as those who might otherwise require fiberoptic intubation or have features that might suggest a moderately difficult airway to manage. That translates into an increased customer base from a business perspective." 2. Improved success rate. Clinical studies show that video laryngoscopy improves intubation success rate. "We have seen these devices increase success rate and make life easier," says Dr. Urdaneta. "Anesthesia providers who trained in a previous era may not see the need to use new equipment, but for those of us who have seen it, the advantages are significant enough for us to make the switch." However, even seasoned veterans are now looking to make the switch. One colleague of Dr. Urdaneta's with more than 25 years of experience in anesthesia was introduced to indirect laryngoscopy with significant results. "He came to me and said that in all his life experience, very few things made a change in the way he saw intubation being taken care with indirect larygnoscopy." 3. Less trauma for all patients. Video laryngoscopy has significant advantages for treating more complicated cases, but also benefits average patients with less trauma and quicker intubation times. "New technology allows us to make intubation easier with less trauma for the patient," says Dr. Urdaneta. "This technology helps us intubate patients faster and improve the overall efficiency at the center." 4. Short learning curve. When compared with other techniques such as bronchoscopy, the video and optical laryngoscopy systems have rel- atively short learning curves, which allow anesthesia professionals to make the switch quickly. "Today's video and optical laryngoscopy systems are easy to use," says Dr. Galgon. "They give us a technical advantage with a short learning curve when compared to the use of traditional direct laryngoscopes. As competition grows, these devices will improve through optimization, become less expensive, widely available, and easier for more anesthesia providers to use." 5. Acquisition costs are reasonable. Financial barriers have kept video laryngoscopy technologies out of the ASC in the past, but prices are coming down as the technology becomes more widespread. "The maximum outlay for a video or optical laryngoscopy system today shouldn't exceed about $12,000 for the capital purchase, and several systems can certainly be introduced for much less," says Dr. Galgon. "Disposables and maintenance costs are reasonable as well depending on the system you use. Further, there is a relatively short learning curve, and most experienced providers should pick up on the subtleties of the systems fairly quickly." n Prodol Meditec S.A., Bilbao, Spain developed and manufactures the Airtraq®. Airtraq® has been marketed world-wide since 2006 and is currently sold in more than 45 countries. The Airtraq® products are sold through an exclusive specialty distributor network that provide on-site training and support. Airtraq® is a guided video laryngoscope device. It is offered in 2 models, Airtraq® Avant which is a reusable optics with disposable blade and the Airtraq® SP (single patient) which is a 100% disposable unit. Airtraq® allows the user a direct view without external monitors or screens. The is an optional external camera and monitor for an external view. Airtraq® has no capital investment. It is designed for routine and difficult airway cases and is ideal for any location intubations may occur, OR, ICU, Code carts, MRI, ER, surgery centers, pre-hospital – EMS and med-flight and military applications. With over 1 million uses, Airtraq® - A simple solution for video guided intubations, WHERE and WHEN YOU NEED IT.

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