©2013 physio-control, inc. video laryngoscope training

©2013 Physio-Control, Inc.

VIDEO LARYNGOSCOPE TRAINING


Introduction

Refer to the McGRATH® MAC EMS Operator's Manual for complete directions for use, warnings and precautions.

Refer to your organization’s protocols or policies regarding the use of the video laryngoscope.


Introduction

The McGRATH® MAC EMS Video Laryngoscope is a tool used to aid the intubation of the trachea. As a rigid laryngoscope, it holds and shapes the anatomy allowing a clear view of the larynx and entrance to the trachea.


ObjectivesUpon completion of this presentation, participants will be able to:

Discuss the features and benefits of the McGRATH® MAC EMS Video Laryngoscope

Understand the basic components of the device Examine the steps for device use Understand how to change the battery Comprehend device cleaning recommendations Review answers to frequently asked questions


Features Overview


Benefits

• Provides both direct and indirect view

• Use in routine intubation as well as difficult airways

• Designed to reduce dental pressure

• Increases working space


Benefit: Improved Grade of View


Device Overview


Blades Overview Disposable, single use Blade lenses are coated with anti-fog

optical surface treatment Slide the blade over the CameraStick™

until the blade clip is firmly latched Remove the blade, lift the clip and pull

the blade off Sizes:

MAC 2: Pediatrics, including infants MAC 3: Adults MAC 4: Large adults


Battery• 3.6V Lithium non-rechargeable battery• Embedded in side of handle• Up to 250 minutes operating time• Battery minutes remaining displayed on screen• Battery icon flashes when five minutes of operating time

remaining• Change battery by pulling the tab on handle• Insert new battery


How to use theMcGRATH® MAC EMSVideo Laryngoscope


How to use: Step 1

If possible, place patient in optimal position for direct laryngoscopy (“sniffing” position).


How to use: Step 2

Look into mouth; insert blade into right side of mouth.


How to use: Step 3

Move device to a central position while sweeping tongue to left.


How to use: Step 4

Advance tip of MAC blade into vallecula.


How to use: Step 5

Visualize epiglottis on screen. Lift anatomy forwards and upwards to expose a

direct and indirect view of glottis.


How to use: Step 6

Advance tube gently through vocal cords.


How to use: Step 7

Indirectly visualize tube placement through vocal cords.


How to use: Step 8

Screen view can be used to confirm correct insertion depth of endotracheal tube.


Cleaning

• Device should be decontaminated immediately after each patient use. • The following methods are approved by Aircraft Medical:


Cleaning Device with Battery in Place

Prepare Ensure cleaning containers, soft brushes and cloths have been decontaminated and are in good condition. Prepare container of detergent in accordance with detergent manufacturer’s instructions.

Clean Hold device above container, and use soft cleaning brushes to remove soil from all exposed surfaces taking care not to scratch optical surfaces. Using a microfiber cloth, wipe all surfaces thoroughly ensuring that detergent solution comes into contact with all surfaces. Periodically rinse cloth and repeat. Scrub crevices and around hinged/mating surfaces with soft brush.

Rinse Hold device over a large volume of rinse water and wipe down to remove all traces of detergent.

Repeat Cleaning and rinsing steps should be repeated if device was heavily soiled or if soiling remains after cleaning.

Dry Carefully hand-dry using clean, absorbent, non-shedding cloth.


Cleaning Device with Battery Removed

Prepare Ensure cleaning containers or sinks, soft brushes and cloths have been decontaminated and are in good condition. Prepare container of detergent in accordance with detergent manufacturer’s instructions.

Pre Clean If visible soiling is present, immerse the device for a minimum of 5 minutes in enzymatic detergent solution prior to cleaning.

Clean Immerse device for five minutes in fresh enzymatic detergent solution. Then, keeping the device immersed, use soft cleaning brushes to remove additional soil from challenging design features. Take care not to scratch optical surfaces. Scrub crevices and around hinged/mating surfaces with a soft brush.

Rinse Remove device from solution and drain over detergent solution before transferring to a clean-rinse receptacle or sink. Rinse device thoroughly with clean water, ensuring that it is fully immersed. Remove device from rinse water.

Repeat Cleaning and rinsing steps should be repeated if the device was heavily soiled or if visible soiling remains after cleaning.

Dry Carefully hand-dry using clean, absorbent, non-shedding cloth.


Rapid Disinfection

1. Monitor: Ensure the wipe gets into the various grooves around screen. 2. Monitor Hinge: Rotate monitor to upright position. Feed wipe into space between monitor and handle to ensure effective penetration. Rotate monitor to its opposite position and repeat. 3. Battery Cover: Ensure joint between battery module and handle are thoroughly treated with wipe. 4. Heel Area: Take particular care in ensuring the small metal clip feature is clean, in particular, internal corner between the clip and surrounding plastic body. 5. Camera: Locally scrub around camera lens to ensure that interface between metal CameraStick™ and camera lens is clean.

A low level disinfection process should only be considered where High Level Disinfection and Sterilization processes are not practical.Ensure that all surfaces of device are covered, even if no visible soiling is present. Systematically work from top to bottom:


Troubleshooting

Behavior Action

No image shown on screen If when switched on, there is no display on the screen:• Replace battery unit.

Poor picture quality If the image displayed on the screen is blurred or fuzzy:• Replace the blade• Remove the blade and check that the image is clear. If necessary, wipe the camera at the end of the CameraStick™ with a clean, soft wipe.


FAQs

Can the disposable blade be re-used?Each blade is single use and is supplied sterile. The blades have been designed to be used once and meet all regulatory and practical strength requirements required for safe intubation.

What blade sizes are available?Three lengths, equivalent to Macintosh sizes 2, 3 and 4.

Does the blade bend?The blade is designed to be as strong as steel. It is made from a robust optical polymer and slides over a reinforced metal alloy CameraStick™ for extra support.

Do the blades fog?No. They are coated with anti-fog treatment which means no need to treat or heat the blade–optical surfaces help eliminate moisture droplets forming.


FAQsWhat do you mean by a direct and indirect view?Direct view is the ability to view the anatomy using the naked eye (as with typical intubation). Indirect view is to view the anatomy using a camera and monitor.

Can I use the McGRATH® MAC EMS for difficult airways?Yes, the device has a number of difficult airway features including a video supported anterior visualization which is designed to improve grade of view and requires less force, addressing tube trauma and complications. The ultra slim-line blade also increases agility and manipulation supporting cases involving small mouth openings and nasal intubations.

Is the McGRATH® MAC EMS for non-difficult airways only?Combining video and direct visualization the McGRATH® MAC EMS supports routine to more difficult intubations and reduces the use of multiple devices. The device invests in existing skills, improves grade of view and avoids complicating more simple intubations.


FAQs

How long does the battery last?The battery lasts up to 250 minutes so the device is always ready to use. The accurate minute-by-minute on screen battery charge indicator also provides useful information.

Is the battery rechargeable?The battery is single use and should be responsibly disposed of when it becomes depleted.

How can I clean the device?Infection control is achieved with sterile packaged blades and fully immersible handle for High Level Disinfection.

©2015 Physio-Control, Inc. Redmond, WA.

GDR 3324404_A. All names herein are trademarks or registered trademarks of their respective owners.


Optional Slides


McGRATH® X blade™

A key distinguishing feature of the X blade is its extreme curvature which is considerably more acute than the existing range of Macintosh-like McGRATH® MAC blades.


Features• A sweeping acute curvature for

extreme anterior airways and for patients where minimal manipulation is a requirement

• Reduced bulk for extremely narrow mouth openings (and optimal tube space)

• Portrait optics to help reduce ‘blind spot’ soft palate injury risks

• Anti-fog to help reduce fogging in the majority of cases

• DepthGuide™ for enhanced training and communication


Indications for Use

• A larynx that is positioned extremely anteriorly

• A mouth opening that is extremely narrow or restricted

• Where the opportunity to manipulate or reposition the patient is extremely limited

• Abnormal or restricted oropharyngeal views

• Traumatized airways where blood and secretions are present


How To Use: Step 1

Load ET tube onto a stylet and form to curvature of X blade


How To Use: Step 2

Elevate patient’s head into “sniffing” position for optimal access.


How To Use: Step 3

• Using a mid-line approach, roll blade into mouth, ensuring anterior side of blade maintains contact with tongue.

• Advance blade until epiglottis is seen on top of screen.


How To Use: Step 4

Place tip of X blade into vallecula.


How To Use: Step 5

Using minimal force, rock device back towards user to lift epiglottis and obtain an indirect view of glottis.


How To Use: Step 6

When device is in optimal position, glottis will be viewed in central upper section of screen.


How To Use: Step 7

DepthGuideTM numeric markings on the posterior side of blade may be used as indication of depth of blade insertion.


How To Use: Step 8

• Insert ET tube at right side corner of mouth.

• Advance in a rolling movement following the curvature of blade, ensuring it maintains contact with section of blade labelled E.T. CONTACT ZONE.


How To Use: Step 9

• When using optimal technique, ET tube should enter screen on right hand side.

• Advance tube until tip is in front of vocal cords.


How To Use: Step 10

• Holding stylet secure, slide tube off stylet and through cords, ensuring stylet does not pass through cords

• Once tube has passed through cords remove stylet completely


How To Use: Step 11

Screen view can be used to confirm correct insertion depth of endotracheal tube.

©2015 Physio-Control, Inc. Redmond, WA.

GDR 3324404_A. All names herein are trademarks or registered trademarks of their respective owners.

©2013 physio-control, inc. video laryngoscope training

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