Section 01
The Call
"An airway you can't see is an airway you can't secure."
The team arrived to a trauma cardiac arrest already in progress. CPR was underway and cervical precautions were in place. A basic airway was buying time, but the patient needed a definitive one.
The paramedic on scene assembled a Macintosh Size 3 blade for direct laryngoscopy. Despite suctioning, blood and mucus blocked the view. The crew could not see the cords, so they backed out, replaced the oral airway, and resumed bagging.
The chief reached for the IntuBlade. The crew plugged it into a 10-inch tablet in the back of the transporting ambulance, resting the screen on the patient's chest as compressions continued. With the C-collar opened and manual stabilization held with a jaw thrust, the blade went in.
Posterior oropharynx, then a tilt. Vallecula, cords. The team paused compressions, and a 7.0 mm ETT passed through the cords on the first attempt.
"We tried manual and could not see anything at all. First you see the vallecula, then you see the cords. We held it right there and slid a 7.0 right in without a problem. It was absolutely beautiful."
"I looked at Larry and I go, 'Hey, hot dog.' He goes, 'son of a b**ch.'"
Section 02
Why Visualization Fails in Prehospital Airways
Prehospital airway management is inherently unpredictable, and providers routinely face extreme environmental challenges. When fluids contaminate the airway, traditional direct laryngoscopy frequently fails to provide the visibility required for successful placement.
Data highlights the clinical challenges of these repeated attempts. As outlined in our analysis of the INTUBE study, repeated intubation attempts significantly escalate the risk of severe adverse events, including profound hypoxemia and cardiovascular instability. Achieving first-pass success is a critical patient safety metric. Large-scale clinical evidence supports a transition in the standard of care. The landmark DEVICE trial (Prekker et al., 2023) demonstrated a first-pass success rate of 85.1% with videolaryngoscopy compared to 70.8% with direct laryngoscopy, as detailed in our review, When Does a Gold Standard Stop Being Golden?.
This shift to a digital-first approach is supported by the highest levels of clinical guidance. The Difficult Airway Society (DAS) 2025 guidelines for managing unanticipated difficult tracheal intubation in adults state that videolaryngoscopy improves safety and efficacy across a range of patients, settings, and operators. Because of this, the guidelines now recommend that a videolaryngoscope should be used first-line to facilitate tracheal intubation whenever possible. For a deep dive into these updated clinical protocols, read our DAS Commentary Part 1 authored by USAF Major Dr. Benjamin Fedeles.
Section 03
The Conversion
"From skeptic to buyer."
A few days after the call, the chief emailed IntuBlade directly to share what had happened. Our founder, Dr. Andrew Napier, called him back. The conversation lasted twenty-two minutes. What follows is from that call.
On Conversion
"I was skeptical in the beginning. Very, very old school. If you can't do it manually, get a decent BLS airway and you're good. After seeing this with the video laryngoscopy, I'm sold. This is great. It changed my mind."
On the Workflow
"The quality of the video was astounding. You know exactly how to manipulate the blade to get the desired effect. You're not guessing."
Section 04
Field Read-Out
7.0 mm ETT secured through the cords after manual direct laryngoscopy failed.
Compliance restored, transport initiated.
Confirmed placement, ventilation normalized.
Stated intent to stock units across the service.
A single field deployment is a reflection of a specific clinical scenario and is not a claim of clinical efficacy. IntuBlade is an FDA registered Class I medical device. RX only. Speaker anonymized by request. Clinical details generalized to protect patient privacy.
Section 05
About IntuBlade
IntuBlade is a wired USB-C video laryngoscope designed for prehospital and emergency airway management. Patented lens-clearing technology preserves visualization in contaminated airways. Single-use, standard MAC geometry, no batteries to charge and no firmware to maintain.
The device pairs with the IntuBlade Connect app on a compatible tablet. Every intubation is automatically recorded and can be streamed into a cloud QA/QI dashboard for medical directors to review.
Section 06