Ivan:

 

I bought the levitan because I know and like and trust Rich, plus I could afford it, plus I liked the idea of it because it pairs nicely with conventional Mac DL, the technique I know best. My only failure with it was in a sea of blood that resulted from iatrogenic trauma. In every other case it has been an absolute "gimmee" (I could always see the epiglottis with the Mac). I have used it in many cases in which it would have been possible to intubate without it, but I wanted to be comfortable and 100% sure. You always have to cut adult size tubes back to about 28cm. Oxygen insufflation is important. This may not be the case if you use a defog, but I have not yet used defog or pre-warmed the device. The obvious downside of oxygen insufflation is the potential for iatrogenic trauma, but I am extremely careful to only go forward when I see where I am. In my favorite case, one in which DL failed a senior EM resident, a senior anesthesia resident and one of my EM attending colleauges, the trauma surgeon asked me in a none-too-trusting way:

 

"Seth, can you see the cords?"

 

I said:

 

"Trish, I can see the carina."

 

It was a moment of deep pleasure. It was also the first time I used the device in a patient.

 

Seth

_____________________________________

Seth Manoach MD
Assistant Professor of Emergency Medicine
Chair, CPR Committee/Rapid Response Program
SUNY Downstate, Box 1228
450 Clarkson Avenue
Brooklyn, NY 11203
-----Anesthideas@yahoogroups.com wrote: -----

To: Anesthideas@yahoogroups.com
From: Ivan Hronek <ivanhronek@...>
Sent by: Anesthideas@yahoogroups.com
Date: 11/01/2007 02:36PM
Subject: [Anesthideas] Optical stylets experiences exchange....

HTML

Were you almost always succesful with the Levitan Seth ?

 

Do you believe it is the least traumatic intubating device ?

 

Have your colleagues or residents liked it, too ?

 

Do you always have to cut the ETT ?

 

Why did you choose the Levitan - is it because it is smaller and more portable than the other ones, Bonfils, Air-Vu, Shikani, Airway RIFL ?

 

Others - please join in this, there are several of our members very experienced with these devices...please join in the discussion.. .thanks !
 

Ivan Hronek MD

SFMC, Los Angeles

cell: 310 487-3288

http://health. groups.yahoo. com/group/ Anesthideas/ messages
"It is better to know some of the questions than all of the answers."- James Thurber

----- Original Message ----
From: Seth Manoach <seth.manoach@ downstate. edu>
To: Anesthideas@ yahoogroups. com
Sent: Thursday, November 1, 2007 11:10:12 AM
Subject: Re: [Anesthideas] Optical stylets experiences exchange....

Ivan:

 

I have three optical devices: levitan, airtraq, and mcgrath. to be honest I've only used the first two in living patients, because the latter is so expensive and small that it's not a great er device (i.e. security reasons). my thought process there is to use a device that my residents may get a chance to use. I am using these in failed or perilous direct laryngoscopy, either for actual patient rescue or as personal MD BP-lowering devices (nothing more reassuring than seeing that tube really go through the goalposts). Massive blood and vomit has caused each of these devices to fail once, and in those cases the intubating LMA went in and did the job (incorporating in-and-out and chandy maneuvers) without a hitch.

 

Seth

____________ _________ _________ _______

Seth Manoach MD
Assistant Professor of Emergency Medicine
Chair, CPR Committee/Rapid Response Program
SUNY Downstate, Box 1228
450 Clarkson Avenue
Brooklyn, NY 11203

____________ _________ _________ _________ _________ __
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