A lot goes into preparing for a successful intubation; gathering equipment, preparing for suctioning and plan-B attempts.
Each of the components – the pieces of equipment – that providers look for, gather and utilize all play into the purchasing plan. Each adjunct, tube, stylet and syringe is a part of a plan toward successfully managing your patient’s airway. As such, there’s a lot to weigh in on. Here are three questions to answer when you’re purchasing airway management devices.
1. What are my long-term expectation for this purchase?
Is your purchase going to be a career-long decision? We often make big purchases and product transitions with the end in mind, and don’t fully respect the dynamics of our industry. In fact, “a long time” within the EMS industry really equates to about five to seven years, when you consider staff turnover, changing guidelines and apparatus service life.
Complete reliance on a single device or a single technique may have the potential to lead us into future hardships, and airway management is no exception.
Take a look at the supraglottic airway device industry, for instance. Consider the new products that have hit the market and the older ones which aren’t in use anymore. How prepared – and poised – is your agency to adapt to these changes? How about your equipment vendor? Do they keep up with the industry changes in order to offer you the top-of-the-line options?
Instead of looking for an airway device that will stick around for the duration of your career, look and plan more acutely. Choose a vendor that has the products that you need and has this dynamic focus in mind. Perhaps your airway device will withstand the test of time, or will only endure minor modifications.
2. How can we reuse, or replace, the device?
Laryngoscopes are a great example of the reuse versus replace consideration. Should you purchase reusable laryngoscope blades or disposable ones?
If you stick with reusable blades, then proper cleaning and disinfecting certainly needs to be a factor in your decision, as well as the increased up-front cost. Disposables, on the other hand, change the dynamic and focus your attention toward long-term costs, rather than up-front costs. Cleaning, additionally, is simple ... you simply discard the used blade.
What do these costs look like to your agency over time? What is the overall impact? Do you have the proper means to clean and disinfect your equipment? Is it time to make a switch?
3. Are there multiple, similar, options available?
The supraglottic airway device industry is full of options. Some involve air-filled balloons to secure the device in place, while others rely on anatomy relaxation and proper seating to accomplish this. If your state, region or agency has no specific requirements over which device to utilize, then variety can work in your favor.
Even in the world of endotracheal intubation, straight, curved and hyper-curved blades are different tools leading toward the same result – successful airway device placement. So, which should you purchase? Are your providers prepared to utilize one over the other, or do they expect to have multiple options available to choose from?
How about video laryngoscopes? Each device seems to have a different blade style, screen location and associated accessories that come along with it, making multiple options available for your consideration.
Which pieces of equipment are reusable versus disposable, and how long do you intend on having this device in service? Options are great to have, but make sure you’re devoting enough thought to your overall purchase, and more effort to secure provider buy-in.
