Kaiser Permanente physician's invention increases patient safety and changes doctors' practice

April 22, 1999

HAYWARD, Calif. – A revolutionary medical device designed by a Kaiser Permanente Hayward anesthesiologist allows physicians to get air into the lungs of patients, fighting for breath, quickly, saving lives in emergency situations. Without oxygen, the patient could suffer brain damage or even die.

Named the WuScope System after its inventor, Dr. Tzu-lang Wu, the device makes it easier to insert a tube into the windpipe so an unconscious patient can breathe—a procedure called intubation.
 

Previously, if a patient could not be intubated with the old, rigid device, the only option was to cut a hole in his neck and push a tube into the windpipe. This procedure, called tracheostomy, is more dangerous and leaves scarring. With the WuScope, even a person who has obstructions in their airway can be intubated.

In normal surgical cases, the patient is anesthetized, then the head and neck are maneuvered to arrange the upper airway in a straight line. This gives the practitioner a clear view along the airway and allows him or her to use a conventional, rigid device to introduce a tube into the larynx.

"This works fine in many patients," explained Dr. Wu, who has served as an anesthesiologist at Kaiser Permanente Hayward for almost 23 years. "But difficulties arise in patients who are obese or have throat tumors, unusually large tongue, or other unfavorable features that make it difficult or impossible for the practitioner to see the larynx. In cases of neck injury involving the spine, using the rigid breathing device is difficult because the head and neck cannot be moved or the patient might be paralyzed."

Until now, the other option has been the use of a flexible, fiber-optic device to visually guide the tube down the airway without straightening it. "However, this procedure takes more time. It doesn't work well in emergencies," Dr. Wu said.

Interested in finding a better way to intubate patients with difficult airways, Dr. Wu worked with Hsiu-chin Chou, MD—Dr. Wu's wife and also an anesthesiologist at Kaiser Permanente Hayward at the time—to develop the WuScope prototype in the early 1990s. Since then the system has been refined.

"It works extremely well for the patients I see," said Matthew Lando, MD, a head and neck surgeon at Kaiser Permanente Hayward. "Many of them have altered airway anatomy because of disease or prior surgery. With the WuScope I have been able to intubate patients normally who in the past I could have intubated only with a tracheostomy."

"I find the WuScope vastly preferable to using a flexible fiberscope for difficult airways," said Scott Andrews, MD, who co-authored a report on the WuScope in the March 1999 medical journal Anesthesiology with fellow Kaiser Permanente Hayward anesthesiologists Susan Norcross, MD, Monique Mabey, MD, and Joshua Siegel, MD.

"It keeps soft tissue out of the way," Dr. Andrews explained. "And the WuScope is ergonomically similar to conventional laryngoscopy, making for a quicker learning curve than the fiber-optic device."

The WuScope is especially helpful for emergency and trauma care, such as victims of car accidents or emergency cesarean sections, according to Jeff Wolfish, CRNA, MSN, chief nurse anesthetist at Kaiser Permanete Hayward and chairman of the nurse anesthetist chiefs for Kaiser Permanente's Northern California region.

"I know of at least three lives saved by the WuScope," said Wolfish. "In each case, experienced practitioners could not secure the airway with traditional tools. The WuScope made it possible to secure the airway and save patients who would have died without it."

The WuScope System is now available through Pentax Medical. More information about the device is available at www.achi.com.

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