the King Vision. There's also the Airtraq, a completely disposable
scope that costs about $90.
• Bronchoscopes. Traditional intubating bronchoscopes are very
expensive, but are the gold standard for difficult airway management.
The difficulty comes in proper cleaning of the suction ports, which if
done incorrectly can lead to patient cross-contamination. An alterna-
tive for a center that does few bronchoscopic cases is the Ambu
aScope3 single-use bronchoscope (about $400).
The most essential tool
With the ever-advancing technology and decreasing cost of difficult
airway video laryngoscopes and stylets, there are few excuses for not
having some type of video technology in your difficult airway cart, no
matter how small the center may be. But we need to remember that
the constant, ever-changing faces of difficult airway management are
anesthesia providers. If their skills and confidence are not consistent
with the technology available, then it doesn't matter what's in the diffi-
cult airway cart.
Nothing can be more frightening, more adrenaline-rushing, more
potentially devastating than being faced with an emergency airway
management case. This patient requires a competent anesthesia
provider who has the skill and confidence to establish a patent airway
in a hurry. The chance of this happening in any of our facilities has
continued to increase over the past several years for a number of rea-
sons, the greatest of which is obesity. That competent provider — that
valuable tool — must be you. OSM
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O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | A P R I L 2 0 1 5
Dr. Chipas (achipas@sc.rr.com), a nurse anesthetist for 42 years as both an educator and clinician, is
the owner of Anesthesia and Educational Services. He frequently lectures at national, state and local
meetings.
