The Tulip has been a constant ally in my daily practice as an anesthesiologist, it has almost completely replaced the use of supraglottic airway devices. It has greatly affected the way I handle airway management for short and moderately long procedures for Malampati 1 to Malampati 3 class patients.  This innovation of the Guedel in my opinion should be present in all areas of the hospital due to its ease of application. It improves ventilation dramatically and may aid efforts in resuscitation of arrested patients.

Post-operatively, we were in the Recovery Unit when the patient was emerging from the anaesthetic and operation. It was obvious that he was in severe respiratory obstruction with a Guedel airway not helping. He was semi-conscious with oxygen saturations of 45% and in an imminent arrest situation. A laryngeal mask could not be passed by the resident staff. The situation changed from calm to panic. You had a size 4 Tulip Airway on your person, and we inserted it and blew the cuff up and there was a patent airway, no laryngospasm, and the onset of normal respiration resumed.  Oxygen saturations normalized and calmness again prevailed. How the staff thanked you and your Airway. It’s funny how memorable that is to me, even though I was an anaesthetist for 40 years! You know, there was always access to a Tulip Airway in my anaesthetic room after that event.

Finally, a course that makes airway management understandable and simple. It covers everything from basic anatomy to difficult airway management and CICO scenarios in a way that actually makes sense. I particularly like the sections on Bronchoscopy, Upper GI Endoscopy and Endotracheal Intubation through the Tulip because this seems to be unique. The patient seems to able to breath spontaneously and the Anaesthetist seems to have full IPPV control throughout the whole procedure.

She was a patient with a difficult airway due to a tumoral lesion of oral cavity. According to the guidelines, awake intubation was required. However, since cooperation could not be established, awake intubation was not considered. After anesthesia induction, firstly Mac D blade Videolaryngoscope was used but we were not successful (DAS Plan A), secondly we wanted to place LMA but we were not successful (DAS Plan B). We considered ventilation with a face mask but we had difficulty in performing ventilation (DAS Plan C).  At this stage when all hope was lost, we placed a tulip and provided better ventilation with the tulip. Finally, we performed intubation with a fiberoptic loaded from the tulip through the Aintree catheter.

The Tulip airway is so different that I thought doing this airway management course was necessary. It is very detailed with the relevant anatomy and all of the other airways that we all use regularly. The course includes Cannot Intubate Cannot Oxygenate scenarios and real world evidence about how Tulip was a life saving intervention is several such cases. This ability could well be useful in my own practice, so I now think that trying Tulip for myself is necessary, not only for me, but also for my patients.