In cooperation with Prof. Dr. Patrick Schoettker from the University Hospital of Lausanne / Switzerland VBM has developed a new malleable intubating guide – the S-Guide.
Very versatile in its indications, the S-Guide can be used during conventional as well as video laryngoscopy. It works especially well with the non-channelled video laryngoscope blades.
S-GUIDE - THE OROTRACHEAL TUBE DANCE
The use of malleable stylets or bougies to assist orotracheal intubation is an integral part of difficult airway algorithms. Their use in routine intubation might also be on the rise with the recent development of video laryngoscopy. Manoeuvrability at the distal end of the orotracheal tube may be necessary to allow advancement beyond the glottic opening into the trachea.
The special stiffness of the S-Guide qualifies it for the technique of the orotracheal tube dance*.
By combining rotation of the orotracheal tube and withdrawal of the S-Guide, a three-dimensional dancing motion of the distal end of the tube can be achieved (Figs. 1 and 2).
The S-Guide should be lubricated and shaped “straight-to-cuff“ with a bend angle at the black mark approaching 35°. Its withdrawal will move the tip of the tube anteriorly while tube rotation will lead to extremity “dancing“. The orange marked tip may protrude past the distal end of the ET Tube.
These conjoint manoeuvres of dynamic S-Guide intubation under videolaryngoscopic view can be extremely helpful in tracheal intubation owing to difficulty in tube advancing beyond the glottic opening, modified anatomy or oropharyngeal tumours.