A Clear Picture

The flexible bronchoscope optimizes intubation in complex situations.

In life-saving situations, ensuring a patient has a secure airway is critical. But in certain cases, when there is trauma to the airway, excessive swelling, or even if the patient has atypical anatomy, intubation can be difficult. STARS has recently added a flexible bronchoscope to its air medical toolkit to help with complex cases, optimizing the efficiency and safety of intubation.

The device is a small camera on the end of a maneuverable scope that goes down the throat and allows STARS transport physicians to see past the vocal cords and into the trachea (windpipe), where they place an endotracheal (breathing) tube.

An unobstructed view

In most cases, when a patient requires intubation, emergency responders use a video laryngoscope, which allows visualization of the vocal cords. But for complications beyond the cords, STARS air medical crew typically need to use a stethoscope or an ultrasound to
determine what is causing the problem. Now, with the flexible bronchoscope, transport physicians can clearly see what’s happening further down the airway and more quickly find an effective solution.

“It gives us a much greater idea and picture of what’s going on with the patient in their airway,” said Dr. Reid Hosford, a transport physician and airway physician educator lead at STARS. “We’re able to actually look down the airway, see where the endotracheal tube is, and see if there are secretions or other issues with the airway, and then actually fix it by changing the tube position, suctioning, or changing the patient’s position to improve oxygenation and ventilation.”

Until recently, these devices were mostly used in hospitals and attached to large towers — too big for small spaces like helicopters. But now, with new disposable scopes that plug into the video laryngoscope screen, physicians can use the camera in air transit. STARS added the tool to its bases in Winnipeg and Calgary two years ago, and in the last year, it has rolled out the device to nearly all of its bases.

“This is a new technology, and we’re continuing to increase the scope of its use to optimize patient care,” said Hosford. “Airways, breathing, and ventilation are very, very important, and so being able to optimize that during transfers will have a big impact on patient outcomes.”