What is Larry Multimodal Airway Management System?An oxygenation-orientated airway management equipment; structured with conventional laryngoscope framework 、high frequent jet ventilation technic and miniature architecture. It serves normal airway and is able to provide multimodal approaches for managing difficult airway、emergency ventilation and resuscitation intractable issues. 

Why it remains conventional laryngoscope framework?

No extra difficult training is required and users can continue the learned skill and knowledge to  command the system

Larryscope can be the first device used for open patient’s mouth as conventional laryngoscope. So that Larryscope is able to deliver oxygen immediately for sever hypoxemia patients before intubation. Meanwhile, Larryscope can assit the procedding intubation procedure with continuous oxygen injection.  

What’s differences between conventional Laryngoscope and Larry System?

Conventional laryngoscope is for assisting intubation only. Once its mission completed, it will be put aside and function-less. But, when Larryscope completes the intubation procedure, the blade will be detached and the handle is to be used as an “miniature HFJV ventilator” afterward. 

What are HFJV ADVANTAGES? 

HFJV is particularly well suited for lung protective ventilation strategies. Low tidal volumes reduce the risk of over-distension and volutrauma. Reduced pressure swings during the ventilatory cycle and increased MAWP optimise end-expiratory lung volume, preventing collapse and cyclic atelectatrauma. A Cochrane systematic review of elective HFJV versus conventional ventilation for respiratory distress syndrome in preterm infants showed no difference in mortality but showed benefit in pulmonary outcomes. Further prospective, randomized trials are needed in adults. ----Abstracted from ATOTW 271 – High Frequency Jet ventilation 08/10/2012  

This type of ventilation can be superimposed on top o conventional ventilation to improve oxygenation and attempt to reduce ventilator-associated lung injury -----Abstracted from  BJA Continuing Education in Anesthesia, Critical Care and Pain ,volume 7 Number I  2007.

What are the miniature architecture objectives?

Integrate all necessary airway management functions within  “one-for-all” architect.   

Let paramedics operate with easiness and less pressure.

Reduce the number of single-functioned devices、light、easy to carry and use. 

What’s the base of the miniature architecture ?

The  Laryngoscope-handle-typed miniature HFJV Oxygen Ventilator ; which can be superimposed to VBM  to improve oxygenation while in airway management and critical care. Meanwhile, it can also be independently used for all critical occasions when users are comfortably used to it .     

What clinical cases constitute an issue to secure the adequate alveolar ventilation using conventional approach?

Cases related to decrease of pliability of lungs and decrease of functional residual capacity (lungs fibrosis, aspiration pneumonia, advanced ARDS, obstruction of  breathing motions, e.g. while backfilled by soil) 

Bilateral disparity of mechanical characteristics of lungs and thorax (unilateral trauma of lungs and thorax, diaphragmatic hernia, bronchopleural fistula, alar pneumonia).

Cases with non-uniform mechanical characteristics of the same side of lungs (emphysema bulosum).。

Cases when minimal pressure effects of artificial ventilation of lungs lead to heavy disorder of hemodynamics (cor pulmonale, natal heart defects, hypovolemia).

Extreme operative act on trachea, bronchi or lungs.

…..etc 

What’s Larry system’s main ventilation options?

What are Larry System’s key specialties ?

1.Transform the conventional Laryngoscope into a new kind of ventilation devices with remaining Laryngoscope‘s function; It provides new ventilation modes which can simultaneously ventilation and intubation.

2.Exert the advantage of high frequency Jet ventilation technics and apnea oxygenation physiology; it can prolong apneic safe time for avoiding from hypoxia injury and release paramedics’ pressure.

3.Bring about a new airway management modal of being able to continuous oxygen delivery and managing airway simultaneously.

4.HFJV is an open breathing system and has no VBM objective restriction; it can manage intractable issues more effectively for difficult airway、emergent ventilation and resuscitation etc.

What’s are the advantages of the new airway management modal ?

Under the operation of Larry system; it will fully exerts the advantage of HFJV、Apneic oxygenation 、 non-confrontation with autonomous respiration auto-PEEP…etc; it can assist insufficient oxygenation or prolong apneic save time to protect patients for the preceding necessary procedures..

Less restriction than VBM has, multiple ventilation options can realize “oxygenation first” guideline ; with effective air exchange protection (may skip pre-oxygenation when necessary), designated airway management process can be conducted simultaneously.

The modal of “oxygenation-first” changes the conventional concept of the “artificial airway is the prerequisite for ventilation ”; so that it can signicantly avoid from hypoxia injury and its complication.

Are there any other functions specifically?

1.Safe ETT Exchange and Extubatoin By using the technique of Hollow Bougie Intratracheal HFJV, under the protection of oxygenation and pre-inserted bougie. ETT exchange or Extubation can be performed and assured with savior and easier.

2.Non-interrupted Continuous chest compression
HFJV is characterized with low tidal volume, low mean airway pressure ,negative exhalation which are proved as important factors to increase ROSC successful rate .

Without confrontation with autonomous respiration、less restriction than VBM …etc. Larry system ventilationcan be easily setup and without interrupting thoracic compression; it can almost achievr the goal of 100% non-interruption and deliver the best physiological result.

3.Incorporated with all conventional airway pieces as a emergency and critical ventilator