To the Editor:—
The CTrach Laryngeal Mask Airway™ (LMA North America, Inc., San Diego, CA) allows for visualization of the glottis before intubation, as well as concurrent patient ventilation.1However, we have found that even after the administration of glycopyrrolate, the use of antifog liquid, or placing the unit in warm water, the view port either fogs or is obscured by either oropharyngeal secretions or the lubricating gel in the endotracheal tube, should the first intubation attempt be unsuccessful. A simple solution to this problem is to use a hemostat or similar device to advance a disposable sponge swab moistened with warm normal saline (e.g. , Item 6075; Sage Products, Inc., Cary, IL) through the CTrach™ to clean the viewing port. We have now used this technique in more than 10 instances, with uniformly excellent results (fig. 1).
Fig. 1. A and B show the CTrach Laryngeal Mask Airway™ with and without optic lens protective sponge swab. C shows the hemostat and protective sponge swab and side view of the CTrach Laryngeal Mask Airway™. D shows the protective sponge swab inserted in the CTrach Laryngeal Mask Airway™.
Fig. 1. A and B show the CTrach Laryngeal Mask Airway™ with and without optic lens protective sponge swab. C shows the hemostat and protective sponge swab and side view of the CTrach Laryngeal Mask Airway™. D shows the protective sponge swab inserted in the CTrach Laryngeal Mask Airway™.
*Cleveland Clinic, Cleveland, Ohio. maurtum@ccf.org