Flexiguide Intubation Guide to Facilitate Airway Management with WuScope System

To the Editor:- We have used the WuScope (Ach Corporation, Freemont, CA) for tracheal intubation in 22 patients. Our experience is in keeping with those who have found it to be a reliable device for this purpose. [1]In all of our patients, the larynx was easily visualized with this bivalve, curved tubular laryngoscope that incorporates a nasopharyngoscope equipped with a high-power optical light source. In four patients, however, we had difficulty in directing the suction catheter that was recommended as a guide for insertion of the endotracheal tube into the trachea. In these patients, intubation was facilitated using a Flexiguide intubation guide (NCC Division, Mallinckrodt, Hook Road Argyle, NY)(Figure 1). The flexible tip of this device can be maneuvered by manipulating the thumb ring at its proximal end. Thus, it is easier to introduce into the larynx than is a regular suction catheter. The technique involves introduction of the WuScope loaded with the endotracheal tube and the Flexiguide into the oropharynx until the epiglottis and the vocal cords are brought into clear view. Then the Flexiguide is advanced into the larynx by appropriately adjusting the direction of its tip. WuScope and Flexiguide are operated with separate hands, thus circumventing any problems that may arise from the combined use of these two relatively large devices. We believe that our technique minimizes the occasional difficulty encountered when intubating with the WuScope.

Daniel O'Neill, M.D.

Chief Resident Anesthesiology

Levon M. Capan, M.D.

Associate Professor Clinical Anesthesia

Rajul Sheth, M.D.

Clinical Assistant Professor of Anesthesiology; Department of Anesthesiology; The New York University School of Medicine; New York, New York

(Accepted for publication April 7, 1998.)