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Fiberoptic Guided Tracheal Intubation through Supraglottic Airway Device (SAD) using Aintree Intubation Catheter

Please ensure the SAD is in place

Give 100% oxygen

Confirm adequate sedation/anaesthesia

Confirm ventilation & paralysis

Aintree Catheter

  • 56cm long hollow catheter

  • 6.5mm outer diameter

  • 4.7mm inner diameter

  • Flexible enough to easily preload onto an "intermediate" sized bronchoscope (maximum external diameter - 4.2mm)

  • Stiff enough to facilitate ETT railroading

  • Comes with 2 "rapifit" adaptors (please refer to manufacturer’s guidelines)

  • Used for SAD assisted orotracheal fiberoptic intubation

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1

  • Lightly lubricate the outer surfaces of both the Aintree Intubation Catheter (AIC) and BS with silicone spray.

  • Preload AIC onto BS and secure with tape.

  • Attach a 15mm bronchoscope swivel connector to SAD.

  • Attach the anesthetic circuit to the swivel connector.

  • Confirm adequate anesthesia, muscle relaxation and assisted ventilation.

2

  • The SAD should be immobilized by an assistant.

  • Introduce BS with loaded AIC through bronch elbow swivel adaptor and into the SAD lumen

3

  • Sequentially visualise SAD aperture bars (if present), glottis, tracheal rings and finally carina as BS passes caudally.

  • Never advance beyond carina.

4

  • Note depth of AIC.

  • Remove AIC securing tape

  • With assistant immobilizing SAD and the operator maintaining the position of AIC, remove the BS 

5

  • Briefly disconnect SAD from bronch swivel adaptor and anesthetic circuit

  • Withdraw SAD while applying counter pressure on AIC to prevent movement.

  • Once the SAD cuff becomes visible, grasp AIC in the mouth and fully remove SAD

  • The process should be done with care.

  • Again, note the depth of AIC at the lips, ensuring that it never exceeds 26cm

6

  • Railroad the 7-0 ETT over AIC

  • Use a conventional ETT - minimum size to fit AIC is 7.0 

7

  • Reconnect circuit and re-establish anesthesia and ventilation.

  • Confirm end-tidal CO2.

  • Consider BS confirmation of ETT position


  •  This should be performed in a controlled stepwise process


  • The process is designed to provide continuous ventilation/oxygenation via the SAD and bronch swivel adaptor until the SAD is removed and ETT is railroaded in place


  • Oxygen can be delivered via the AIC in situations where railroading of tracheal tube is prolonged; assisting ventilation via this route is often suboptimal (narrow diameter/lack of cuff) 


  • Refer to manufacturer’s guidelines for methods of oxygen delivery.


  • Additional Recommendations

  1. Consider a second anesthesia provider in addition to a trained assistant.

  2. The Aintree catheter is not recommended with the LMA Supreme

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