D E C E M B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 1 1 1
Through
The Cords
Total Control Introducer
ttcmed.com
For anesthesiologists, a
recurrent problem —
and a great source of
stress — is managing
difficult airways, espe-
cially in high-BMI patients and those with sleep apnea. It's the balanc-
ing act of anesthesia. Patients can die if you're unable to ventilate
them. Sometimes in these urgent situations, anesthesiologists panic
and get fixated on intubation. My recommendation in these situations
is not to immediately intubate, but to take a step back, bag mask ven-
tilate and buy time. Our most important skill is ventilation, not intuba-
tion; I keep drilling this into anybody who will listen. To me, the most
common preventable cause of aspiration is premature attempts at
laryngoscopy.
Sometimes, though, intubation is the only option. This product
offers an intriguing approach to addressing difficult airways and first-
pass failure in emergency intubations by turning your video laryngo-
scope into a difficult airway management system. The Total Control
Introducer has a flexible shaft, a tip that articulates both up and
down, and a color-coded depth control system, as well as a removable
pistol-grip handle that lets you place the tube over the introducer
once in place in the trachea, removing the need to preload the tube on
the device. The idea is to give the anesthesiologist precise introducer
tip control at the level of the vocal cords. The vendor positions it as a
rescue tool that's easy to reach for when needed, and a disposable
alternative to more expensive reusable fiberoptic bronchoscopes.
