Text written in Basque and translated automatically by Elia without any subsequent editing. SEE ORIGINAL

Facilitating difficult intubations

It is very common for the patient to fall asleep under anesthesia during operations, and in many of these cases, the patient is intubated to keep his breathing under control. A Greek doctor has invented a new laryngoscope.

We have just seen that it is very common for the patient to fall asleep under anesthesia during operations, and in many of these cases, the patient is intubated to keep his breathing under control. They insert a tube that goes from the mouth to the end of the larynx and thus cause artificial respiration. They use a tool called a laryngoscope to allow the tube to penetrate through the vocal cord and pharynx. But in some patients the insertion of the tube through the respiratory tract is very difficult, and in these cases the patient is at risk of death. Trying to deal with these difficult cases, a Getxo doctor has invented a new laryngoscope, which

has been used in most hospitals in the Basque Country.

His name is Airtraq. It is made of plastic and is for single use only. Its appearance does not have much in common with the traditional laryngoscope commonly used in operations.

The traditional one is made of metal, which, sterilized, can be used many

times. Both have the same function. Assist in inserting the tube necessary to induce artificial respiration through the airway. The Airtraq laryngoscope is the invention of the Getxo doctor

Pedro Atxa. The product was released three years ago and is currently used in hospitals in 44 territories around the world.

PEDRO ACHA; Founder of Airtraq: Establish me in the third place of medicine, and fundamos, I and three other companies DYA of Getxo, do not have the service of urgencies, and let us work and vimos muchos casos

de vía aérea difícil (...) descubrimos que había vías aéreas muy complicadas, let us think and design prototypes. I was in the third year of medicine and together with three other people we created the DYA of Getxo. Then there was no emergency service and we started working. We realized that there were very difficult airways and we started thinking and designing

prototypes. Between 5 and 7% of all intubation cases are highly complex intubations. The Airtraq laryngoscope is helpful in these intubations with special risk.

In the operating rooms of the Galdakao-Usansolo Hospital, we had the opportunity to see how they use Airtraq.

In the operating room, the anesthesiologist is responsible for intubating the patient. Immediately after entering the operating room, they will try to oxygenate the patient as much as possible through an oxygen mask.

In the meantime, to eliminate the pain of the operation, you will be given anesthesia along with a sedative. This sedative will allow the vocal cords to relax and allow the anesthesiologist to have free access to the intubation tube downstream of the larynx to the trachea. But this sedative, in addition to the vocal cord, will also relax all the muscles of the

body, including the lungs, which will stop working. This is the most dangerous moment. In fact, from that moment and until the doctor finishes the intubation, the patient will be without breathing. The anesthesiologist will have a total of 8 minutes to perform the intubation and keep the patient under control through artificial respiration.

IRATXE GONZALEZ; Anesthesiologist: If you can't intubate, that patient can't breathe. So if you wake her up, she won't be able to breathe, so you have to ventilate the patient. Ventilate, if you can, well, because you will keep saturation and breathing artificially, but you will keep it. But if you can't ventilate, then the patient could die. In order to

be able to work with a conventional laryngoscope, the physician has to retract the patient's head and place it in a state of hyperflexion.The pharynx, the larynx, and the vocal cords, he sees them in line like this. This is the way the tube has to travel to the trachea. By pulling the tongue to one side and exerting an upward force on the laryngoscope blade, in most cases the tube can be easily inserted through the vocal cords.

Difficulties begin when there are problems with visualizing the vocal

cords. PEDRO ACHA; Founder of Airtraq: If you are not living the vocal cords you can attempt a intubation to the ciegas, with the shovel, but corres riesgo

de equivocarte to the meter the tube in the exófago, if you are the cord you can remedy but and if you are not the cord, the time runs, and that person is already relying on the piece to give you an oxygenation and a final stop to the pairing. If you don’t see the vocal cords, you can try a blind intubation with the blade, but if you mix it, you can direct the tube to the esophagus, and if you don’t notice it, the patient’s oxygenation may start to go down and the heart may stop.

On the other hand, with the Airtraq laryngoscope, the visualization of the vocal cords is not very difficult and facilitates difficult

intubations. IRATXE GONZALEZ; Anesthesiologist: You don’t have to cause neck hypertension when you enter, so you enter the Airtraq and with that you start looking through the screen and usually look great when you first enter the vocal cords. You don’t have to align the three axes, so you enter Airtraq, you will see the vocal cords and if intubation is difficult, it improves the degree of intubation.

PEDRO ACHA; Founder of Airtraq: This device when we are looking for designs that have some cavities in it, the first time we see it, the second time we see the tube, the third time we see it, the second time we see it, the third time we see it, the second time we see it, the second time we see it, the third time we see it, the second time we see it, the second time we see it, the third time we see it, the second time we see it, the second time we see it, the second time we see it, the second time we see it, the second time we see it.

When we started designing this tool, we were looking for some features. The first was that the apparatus had a visor; the second was that it had a way of guiding the tube; the third was that the instrument had the necessary angle so that the patient's head did not have to be moved. Finally, we wanted to have an anti-fog system.

The Airtraq laryngoscope is particularly effective in intubations in children. The risk increases during these intubations, as doctors only have about 3 minutes to intubate the child. It

can also be very helpful in emergency situations. For example: it is used to intubate a patient who is not fasting for a very short time, or to intubate a patient who has polytraumatisms due to an accident without reversing his or her head.

Many cases of dangerous intubations can be detected in advance through the tests that the doctor performs during the consultation. Many other difficult cases, however, are encountered by the anesthesiologist at the same time as the operation.