We have this device and I personally think it's a waste. To me, the major purpose of the device has to be to eliminate the use of a bronchoscope. If you don't eliminate the bronchoscope from the equation, then you're just increasing your cost without any additional benefit of the device. Here are the issues that I've encountered:
CONS:
- The flush port is not THAT effective. And let's say you have a situation where literally no matter the flushes you do, it doesn't get rid of the gob on the screen. You can flush air or saline as your 2 options for troubleshooting per the instructions. you can then use a suction catheter down the lumen of the tube to get rid of excess stuff. The suction catheter down the lumen goes right next to the screen which can introduce gobs of stuff to the lens. So you inevitably can go back and forth with flushing / suctioning without making progress. You then are forced to pass a bronchoscope which defeats the purpose.
- You cannot confirm RUL takeoff with a static camera incorporated into the tube. So, if tube dislodges or you aren't watching for carina on tube placement, then you lose your orientation. This was an especially noticeable problem with a patient who had tracheomalacia and lots of secretions. Not to mention you may confirm positioning on placement, but then after turning them into lateral decubitus the tube shifts around without you watching, and you could lose your positioning and not find it again unless you had the RUL takeoff landmark.
- You cannot perform a bronchoscopy with it unless you open a bronchoscope, so no focused pulmonary toilet / suctioning unless you spend the money on opening a bronchoscope.
PROS:
In a straight forward VATS wedge or something similar, it COULD eliminate the need for a bronchoscope, therefore the need to open one less piece of equipment.
