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Difficult intubation

CHALLENGE

Airway management covers a set of techniques which are commonly practised in anaesthesia and outside the operating theatre.
Several studies have shown that in intensive care or in the emergency department, the rate of complications is higher where tracheal intubation fails (1). Medical societies agree on the need for a bronchoscope to be immediately available in intensive care departments in order to cope with unexpected events arriving during difficult intubation (1,2). The Broncoflex®, in its sterile packaging, can be easily stored and is always ready for use in all circumstances and at any time.

THE BRONCHOSCOPE, NECESSARY ALTERNATIVE IN THE EVENT OF DIFFICULT INTUBATION

According to medical societies, difficult intubation is when tracheal intubation, regardless of the technique used, fails 3 times (or 2, depending on the country).

This occurs in 10 to 20% of intubations in intensive care patients, with a related increased risk of morbidity from serious complications (hypoxia and related risks: brain damage, cardiac arrest) (2).

Risk of complications after 3 intubation attempts using a laryngoscope.
Study of 10,000 difficult tracheal intubations over a 10-year period (3).

x14

Risk of
severe hypoxia

x6

Risk of oesophageal
intubation

x7

Risk of
regurgitation

x7

Cardiac
risk

Unavailability during retreatment

ALWAYS AVAILABLE AND STERILE,
THE BRONCOFLEX® S ALTERNATIVE

These data and studies show that in the event of difficult intubation, it is preferable to use other appropriate methods. If not, the risk of complications increases significantly. Medical societies recommend having various types of equipment, including a bronchoscope as alternative to a laryngoscope, on hand on a difficult intubation emergency trolley, for use after several unsuccessful attempts (1,2).

image GREATER AVAILABILITY

GREATER AVAILABILITY

The Broncoflex® removes all need for disinfection, repair and maintenance of reusable bronchoscopes. It is always available and can be stored in your emergency trolley, ready for use, 24/24, 7/7.

image PACKAGED IN A STERILE BAG

PACKAGED IN A STERILE BAG

Having a sterile bronchoscope at hand in all circumstances reduces the risk of cross-contamination for patients and is cost and time saving (4).

image FIXED COST, MANAGED BUDGET

FIXED COST, MANAGED BUDGET

Contrary to popular belief, medico-economic studies show that the cost of use of a single-use endoscope is equivalent to that of reusable endoscopes, and can save costs depending on the situation (5).

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Bibliography

1 - Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society)
2 - Intubation difficile et extubation en anesthésie chez l'adulte - Société française d'anesthésie et de réanimation (Sfar).
3 - Emergency Tracheal Intubation: Complications Associated with Repeated Laryngoscopic Attempts
4 - Anderson, Deverick & B Kirkland, Kathryn & Kaye, Keith & A Thacker, Paul & Kanafani, Zeina & Auten, Grace & Sexton, Daniel. (2007). Underresourced Hospital Infection Control and Prevention Programs: Penny Wise, Pound Foolish? •. Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. 28. 767-73. 10.1086/518518.
5 - McCahon, Robert & K. Whynes, D. (2015). Cost comparison of re-usable and single-use fibrescopes in a large English teaching hospital. Anaesthesia. 70. 10.1111/anae.13011.