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Self-Intubation (Airway RIFL)
Self-Intubation (Video RIFL)
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Case 1: 75 y/o female, 162 cm tall, weighing 95 kg. Preoperative airway assessment: short neck, Hyomental distance >3 finger widths, oral opening >3 cm, and a Mallampati III airway. Ventilated with a 3.5 airQ® SGA post-induction. The video RIFL® was loaded with a 6.5 mm ETT and inserted through the inner lumen of the SGA for intubation. As seen in the video the articulation of the distal tip enabled advancement of the endotracheal tube under direct visualization. (Stevin Dubin, MD)

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Case 2: 64 y/o male, 170 cm tall, weighing 65 kg. Preoperative airway assessment: Hyomental Distance > 3 finger widths, oral opening >3 cm, and Mallampati II airway. Known prior SCCA of vocal cords. After induction the clear RIFL blade adjunct was used to hold tongue - airway found to be anterior and required full handle flexion. (Harsha Setty, MD, MSE)

Case 3: 53 y/o male with a known history of a difficult intubation - during earlier procedure he required nasal FOB intubation after unsuccessful oral attempts using: Macintosh Blade, Miller Blade, Glidescope Portable GVL, and Dido Laryngoscope. None of these adjuncts allowed visualization of the vocal cords. In subsequent procedure oral intubation was unsuccessfully attempted using: Macintosh blade, Miller blade, Glidescope Portable GVL, and Anterior Commissure Scope. Retrograde intubation was successful using a bougie catheter.

Preoperative airway assessment: Mallampati III, oral opening > 3 cm, hyomental distance = two cm. Pt recently went through radiation therapy. The video RIFL® was used as the primary intubation device in the upright sitting position with 7.0 mm Parker-flex endotracheal tube. Video RIFL® insertion was performed once and the tube was seen passing through the vocal cords. The anatomy of the patient indicated that the true vocal cords were inferior relative to the opening visualized on prior laryngoscopy. He was awake and compliant with the entire procedure. (Harsha Setty, MD, MSE)

Case 4: 19 y/o male in cervical collar s/p trauma. His airway exam revealed: Hyomental Distance >3 finger widths, oral opening >3 cm, and Mallampati III airway. Cervical collar had not been cleared prior to surgery. Video RIFL used with 7.5 ETT while keeping cervical collar in place. Clear RIFL blade used to provide channel for scope passage after induction. (Thomas Gallen, MD, MPH)

Case 5: 42 y/o male brought to ER obtunded. His airway exam revealed: Hyomental Distance >3 finger widths, oral opening >3 cm, and Mallampati III airway. Video RIFL used with 7.5 ETT alongside MACintosh 3 blade to secure tongue. ETT placed with view of tracheal rings for immediate confirmation of endotracheal placement. (Richard Schwartz, MD, FACEP)

 

Sample Images from Composite Output on Video RIFL(R): (Harsha Setty, MD, MSE)

Epiglottis at tip of MAC 3
Epiglottis at tip of MAC 3

Tracheal Rings
Tracheal Rings

Grade One Equivalent View
Grade One Equivalent - TVC recessed

ETT being passed
ETT passing through Vocal Cords via SGA

 
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