Audit of use of size 3 Yeescope in a paediatric anaesthesia practice

J.M. McDonald
Sydney, New South Wales

An audit was designed as a pilot to assess the potential for the size 3 Yeescope to be used as the only laryngoscope in a broad paediatric practice. The author has a mainly paediatric anaesthetic practice partly in a major paediatric teaching hospital but also in smaller hospitals and major general hospitals with small paediatric services. In these environments, which are less specialised from a paediatric perspective, there will usually be a more limited range of paediatric equipment available than in referral paediatric centres. Neonates and babies in the first months of life are not usually managed outside specialised referral centres. This letter reports an audit of using the size 3 Yeescope for intubating paediatric patients having routine procedures under anaesthesia in a single paediatric anaesthesia practice.

The Yeescope is a locally designed and manufactured single use laryngoscope, developed to address the problems of bulb failures and hidden sterilisation costs associated with endotracheal intubation1,2. The absence of an articulating electrical connection (as present in many types of laryngoscope) makes failure of illumination unlikely even when some force is applied to the blade. The traditional re-useable MacIntosh laryngoscope is heavier and more cumbersome than the plastic Yeescope. The Yeescope blade design allows the size 3 blade to be used in children for which size 3 MacIntosh blades would be too large. The Yeescope is presented in a sealed packet and is marketed in Australia and internationally by Tuta Pty Ltd.

The patients were all managed by the author and were having either dental or general surgical procedures or medical imaging. All children were ASA I or 2. Ages ranged from four months to 14 years (Table 1). Most patients were not paralysed at the time of intubation. In all cases, the Macintosh technique of inserting the tip of the scope into the vallecula to lift the epiglottis was used. In some of the patients external pressure on the larynx was used to bring the larynx into view. In no case did the light fail (a relatively common complication of the use of traditional “separate blade and handle designs”3). In smaller patients, the blade was a little bulky in relation to mouth size, but, as only the tip of the flat part of the blade is inserted, the instrument still provided good intubating conditions. No failures of intubation or other complications were noted.

TABLE 1
Age and weight of patients.

In this audit, the size 3 Yeescope was suitable for laryngoscopy in general paediatric use. It was not used in children less than 4four months old. Only six cases audited were less than a year old. On the basis of this audit and extensive personal use, the author suggests that the Yeescope size 3 could be suitable for emergency trolleys and retrieval packs where children over the age of six months are to be managed.

Declaration: The author has no financial interest in the Yeescope.

REFERENCES

1. Yee K. From concept to commercialisation. Australian and New Zealand College of Anaesthetists. Bulletin, March 2005
2. Holland R. The inventors. Anaesth Intensive Care 2006; 34 (Suppl 1):33-38 [PubMed]
3. Yee K. Decontamination issues and perceived reliability of the laryngoscope - A clinician’s perspective. Anaesth Intensive Care 2003; 31:658-662 [PubMed]