Non-Glare Material Helps Portable Video Laryngoscope Provide Clear View for Emergency Intubations
Verathon Medical Canada has begun producing its video laryngoscopes with Clarex non-glare materials, allowing for higher-quality, lower-risk medical care to be provided both in and out of a hospital setting.
"Millions of fast intubations are performed every year in military and emergency situations where extreme conditions and severe trauma are common. Key to the success of the intubation is a clear view of a patient’s airway. We feel we have achieved the ideal solution with our battery-operated laryngoscope system that uses a hardened non-glare screen to achieve optimum display clarity and provide a clear view of the intubation procedure. The system holds the tongue out of the way, helping the anesthesiologist move the jaw downwards, and has a ‘light bulb’ that acts as a flashlight to light up the inside of the mouth. Having a clear view of the vocal cords helps the technician insert the endotracheal tube through the cords into the trachea. The digital display is a critical component of our system, providing the clear image in all environments and conditions.”
Dr. Jack Pacey, MD FRCSc, President of Verathon Medical Canada ULC, discusses his company’s use of Clarex Non-Glare materials, provided by Astra Products, that helps their GlideScope achieve the “direct vision” that is critical during the intubation procedure. Dr. Pacey states, “When developing the miniature screens, image quality presents a significant challenge. Displays must have superior brightness, contrast, accurate color transmission, and good uniformity all within the available space. Using a non-glare material that efficiently transmits light and prevents reflection optimizes the viewing area legibility.”
Verathon Introduces the GlideScope
Verathon Inc. (formerly Diagnostic Ultrasound Corp.) designs and manufactures reliable, state-of the-art medical devices and services that offer a meaningful improvement to in-patient care for the health care community. The company’s noninvasive BladderScan instrument is the standard of care for bladder volume measurement. The company markets products in more than 60 countries for Urology and Primary Care practices, as well as Acute and Extended Care facilities. The January 2006 acquisition of Saturn Biomedical Systems allowed Verathon to enter the Anesthesiology, Critical Care, and Emergency markets with the GlideScope Video Laryngoscope product. Recently experiencing double-digit growth, Verathon was ranked among the fastest growing technology companies in Washington State in Deloitte’s prestigious “Technology Fast 50” program for both 2005 and 2006.
“Video Laryngoscope incorporates micro-video technology and is effective in dealing with standard and difficult intubation cases,” explains Dr. Pacey. “The GlideScope product group, originally introduced in 2001, offered a revolutionary approach to the ‘airway dilemma’ of medium and difficult intubations continually facing Anesthesiologists. The durable GlideScope Ranger, introduced in late 2006, can be used quickly and easily in conditions ranging from desert to arctic environments, in moving vehicles, and situations where the patient is in an unusual position such as sitting.”
The GlideScope Ranger provides a clear picture of the larynx and vocal cords on a display monitor, enabling visual control of the endotracheal tube in its trajectory toward the airway. With its patented 50 to 60 degree viewing range, integrated camera, and patented anti-fogging mechanism, the Ranger facilitates fast, accurate ETT placement in difficult airways, and helps prevent improper ETT placement and related complications in emergency, out-of-hospital situations. The Ranger is compact (measuring only 7 1/4 x 6 3/8 inches), weighs less than two pounds, and is operational within seconds. With its rugged, high-impact plastic construction, the Ranger was designed to be dependable in an array of field conditions, including temperatures of -4° to 122° F, humidity up to 100 percent, and altitude up to 20,000 feet. The integrated, rechargeable lithium polymer battery provides a minimum of 90-minutes of continuous use autonomy, and allows for approximately 20 intubations per battery cycle (depending on usage).
Dr. Pacey adds, “The Ranger was the result of military physicians needing a portable video laryngoscope that not only provided a clear airway view, but was also compact, lightweight and airworthy. The Ranger, designed for ‘1st Pass Success’ in military and emergency situations, features a patented blade angulation, a non-glare monitor that is easily visible in bright light, an anti-fogging mechanism that resists lens contamination, and rugged, high-impact construction. The Ranger does not require ‘line of sight’ for view and takes less force than traditional methods, helping eliminate trauma to patients. It provides a C/L Grade I or II view 99 percent of the time, even in difficult airways.”
A Little History
Endotracheal intubations performed in an out-of-hospital setting carry a greater risk of improper tube placement and other complications. Clinical studies report that in these situations up to 25 percent of endotracheal tubes are misplaced, with 66 percent of misplaced tubes being inserted into the esophagus. In a study of patients with severe head injuries undergoing endotracheal intubation, the odds of death were approximately four times greater for patients intubated outside the hospital. The odds of poor neurologic outcome and moderate to severe functional impairment were also increased for those patients undergoing out-of-hospital intubation.
Dr. Pacey adds, “While GlideScope Ranger was designed to meet the needs of military physicians and paramedics who work in extreme conditions, we are getting great feedback from non-military practitioners who appreciate the advantages of the instrument. We also feel that the GildeScope Ranger has potential application in Telemedicine.
“Recently, a Colonel in the USAF tested the GlideScope Ranger at a trauma center in Baltimore, Md., and he commented, ‘I believe the GlideScope Ranger has a potential role with many of our deployed medical units and may be an excellent adjunct when non-expert airway managers are available. The relatively short learning curve has also been beneficial since we have a large number of personnel that train with us for airway management.’”
Clarex optical quality acrylic materials are specially formulated to optimize performance of LCD, LED, VFD, EL, PD, and other flat displays. Cast in lightweight acrylic in a wide range of grays and colors, Clarex materials offer high light transmission, weatherability, and impact resistance. Clarex materials are currently used in medical and industrial instruments, marine and automotive electronics, cell phones, notebook computers, video cameras and avionics, among others.
The materials provide excellent protection of the display, while enhancing contrast and minimizing glare. Manufactured using proprietary technology, Clarex materials offer thousands of configurations to meet every flat screen application. The material is a cell cast polymethyl methacrylate with additional coatings to prevent surface scratching, reflection, and smudging.
For the GlideScope Ranger application, Verathon specifies Clarex AR clear material for its optical quality, impact resistance, uniform thickness, and high percentage of light transmission. The seven inch screen in the battery operated hospital unit is a fluorescent TFT backlit LCD screen, and the 3.5 inch screen in the Ranger unit is an LED TFT LCD backlit display. Dr. Pacey adds, “We have had such success with the Clarex material that we are considering it for the Bladder Scan product line in the future.”
Clarex materials are available in clear, six neutral grays, and a wide assortment of colors, with adjustable light transmissions and thicknesses, to help satisfy a plethora of applications. The materials are available in thicknesses from 0.008 inch to 0.197 inch, and are available with special coatings and surfaces for unique applications such including EMI shielding, anti-reflective, conductive, scratch resistant, anti-bacterial and others.