King Systems King Vision aBlade User manual

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KING VISION®
VIDEO LARYNGOSCOPE
Instructions for Use
For use with aBlades
Fig. 1
#1 Display
#2 Video Adapter,
Size 3-4
#3 Standard Blade,
Size 3
#4 Channeled Blade,
Size 3C
#5 On/Off Button
#6 Battery Indicator
Light
#7 Video-out port
#8 Battery Compartment
#9 Battery Door
# 10 Distal Window
#11 Channeled Blade,
Size 2C
#12 Standard Blade,
Size 2
#13 Standard Blade,
Size 1
#14 Video Adapter,
Size 1-2

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Product Overview and Description
The King Vision® aBlade Video Laryngoscope is a portable, battery operated, rigid, video laryngoscope
system that incorporates an integrated reusable display, two reusable video adapters and a choice of
disposable blades. It is designed to examine and visualize a patient’s upper airway and aid in the
placement of a tracheal tube.
Product Components
The King Vision aBlade Video Laryngoscope consists of the following components:
1. A integrated reusable display (Fig. 1, #1)
2. A reusable video adapter (Fig. 1 #2 and 14)
3. A choice of disposable blades, with or without a channel for tracheal tube guidance (Fig. 1, #3, 4,
11, 12 and 13)
An optional video-out cable for connection to an external monitor is also available.
None of the product components are made with natural rubber latex.
Note: all components are supplied clean, non-sterile, ready to use.
Reusable Display (Fig. 1, #1)
The main reusable component of the King Vision aBlade Video Laryngoscope is a durable, high quality,
portable, battery operated display with a TFT LCD (Thin Film Transistor Liquid Crystal Display) screen. It
incorporates technology to receive images from the distal tip of the video adapter and displays the image
on the integrated full color, anti-glare screen. The reusable display has an on/off switch (Fig. 1, #5), a
battery indicator light (Fig. 1, #6) and a video-out port (Fig. 1, #7) It incorporates an advanced power
management system with automatic gain and exposure control. Power is provided by three AAA batteries
housed in the battery compartment (Fig. 1, #8).
Reusable Video Adapter (Fig. 1, #2 and 14)
The second reusable component of the King Vision aBlade Video Laryngoscope is a video adapter that
connects to the display in order to transmit an image to the display when turned on. The video adapter
comes in two sizes and each video adapter includes an LED light source and CMOS camera housed in the
distal tip.
Single Use aBlades (Fig. 1, #3, 4, 11, 12, 13)
The disposable component of the King Vision aBlade Video Laryngoscope consists of a choice of disposable
blade versions:
The King Vision Channeled aBlade
(Fig. 1, #4 and 11)
The King Vision Standard aBlade
(Fig. 1, #3, 12 and 13)
The “Channeled” blade incorporates a guiding
channel to facilitate delivery of an endotracheal
tube (ETT) to vocal cords. Channeled blades
accommodate a specific range of ETT sizes. No
stylet is needed.
The “Standard” blade contains no guiding channel.
As such, these blades will likely require the use of
a stylet to assist in delivering the ETT to the vocal
cords.

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Both blade versions slide over the video adapter and connect to the reusable display, completing the King
Vision aBlade Video Laryngoscope. The distal window of the blade has an anti-fog coating to prevent
condensation from affecting the image (Fig. 1, #10).
Blade sizing is intended to be consistent with standard rigid laryngoscopes. This means that the size 3
aBlades (both channeled and standard) should be considered for the same patient population as a
standard Macintosh size 3 blade. The aBlades size 1 and 2 should be considered for the same patient
population as a standard Macintosh or Miller size 0 to 2.
Size Selection
The King Vision aBlade system offers a complete range of video adapters and disposable blades for a wide
range of patients. Make sure that you select the video adapter and aBlade that is the best fit for your
patient.
For infants and children the small video adapter 1-2 and associated blades are indicated:
 aBlade size 1 (Infant patients <4 years)*
 aBlade size 2 + 2C (Child patients 1 –10 years)*
For larger children and adults the large video adapter 3-4 and associated blades are indicated:
 aBlade size 3 + 3C (Children > 5 years and Adults)*
*Size ranges are based on teeth-to-vallecula data for the given ages, tracheal tube sizing recommendations
and actual experience. A medical professional must evaluate on a patient-by-patient basis.
Age
Size 1
Size 2
Size 3
0
1
2
3
4
5
6
7
8
9
10
11+
Indications For Use:
The King Vision Video Laryngoscope is a rigid laryngoscope used to examine and visualize a patient’s
upper airway and aid in the placement of a tracheal tube.

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WARNINGS AND PRECAUTIONS:
The King Vision aBlade Video Laryngoscope should only be used by individuals who have been trained
and authorized to provide patient care with this device (intubation).
Warning: Do not store batteries in the King Vision Display for long periods of time as they may leak and
cause damage to the Display. The King Vision Display may experience a small amount of current leakage
if stored with batteries, even when the Display is turned off.
Even if it is turned off, the King Vision Display may experience a very gradual loss of power if stored with
batteries installed. As such, it is recommended that the user replace the batteries in the unit as directed
by the battery indicator light or on a quarterly basis if not used regularly.
Warning: No modification of this equipment is allowed.
Warning: The King Vision aBlade video adapter contains a light source that could cause the blade surface
temperature to exceed 41°C when used near the upper limit of the operating temperature range
specified for this product (e.g., during one test, 42.1°C was measured on the blade surface in an
operating temperature of 40 °C). Patient tissue damage can occur from direct contact with surfaces
exceeding a temperature of 41°C for a prolonged period of time. As such, patient contact time should be
minimized when used near the upper limit of the operating temperature range.
CAUTIONS:
The King Vision Display is designed to be used ONLY in conjunction with the King Vision Video Adapter and
King Vision aBlades. The King Vision Video Adapter should not be inserted into the mouth without a King
Vision aBlade attached.
Direct visualization of the vocal cords (direct line of sight) from outside the mouth should not be expected
with the King Vision Video Laryngoscope.
Do not submerge the King Vision Display in any liquid as this can damage the display. Failure to follow the
cleaning and preparation for use instructions may compromise the performance of the system and may
void the warranty.
Do not put pressure on the teeth with the King Vision Video Laryngoscope.
Do not use excessive force to insert the aBlade into the mouth.
Reported complications of endotracheal intubation using video laryngoscopy include: mucosal injuries,
perforations, tears, edema, sore throat, TMJ injuries, nerve injury.
Always confirm placement of the endotracheal tube using accepted methods.
Not suitable for use in the presence of flammable anesthetics.
Before use, the outer surface of each blade should be checked for unintended sharp edges, protrusions,
visible cracks, or rough surfaces which may cause harm; if present use a different blade.
If an unpackaged blade is dropped prior to use, discard and replace with a new clean blade.

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Care must be taken when handling the video adapter. Do not pull or bend the flexible portion of the video
adapter excessively.
CAUTION: Federal (U.S.A.) law restricts this device to sale by or on the
order of a physician or other appropriately licensed medical professional.
Acquiring an Image
Important: The King Vision Display must be “off” before attaching the video adapter; otherwise the
video image will become distorted. If this happens, simply turn the Display OFF then back ON. If, after
the pre-use check with the video adapter attached, the video screen on the Display does not show
moving images, follow these steps:
1) Check to make sure the Display and Video Adapter are properly attached to each other by
separating them and then reattach.
2) Cycle the power OFF, then back ON.
3) Replace the Video Adapter
4) Replace the Display.
Note: If the King Vision aBlade Video Laryngoscope is in the patient’s mouth when this occurs, remove
it before troubleshooting the loss of image.
General Recommendations
New and first-time users should practice using the King Vision aBlade Video Laryngoscope in a mannequin
before clinical use of the product.
Prior to use for a difficult airway, users of the King Vision aBlade Video Laryngoscope will benefit from use
on patients with normal anatomy.
The King Vision Display and Video Adapter should be inspected prior to each use by the user. If visible signs
of damage or problems with the display or video adapter are found, replace the damaged item.
Battery Installation / Replacement
Three (3) Disposable Size AAA Alkaline Batteries are Recommended
 Obtain access to the battery compartment on the reusable King Vision Display (Fig. 1, #8) by
removing the video adapter (Fig. 1, #2, 14) or battery door cover (Fig. 1, #9).
 Dispose of used batteries in accordance with local environmental policies. Do not mix new and
used batteries together in the display.
 Install / replace the 3 AAA batteries on top of the pull ribbon following the guide located in the
battery well. Ensure that the lower battery is properly seated in the battery compartment.

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 Attach the unlocked video adapter ( ) by sliding it up, towards the video screen. Then slide
locking mechanism up until the yellow stripe is no longer showing. It should click/snap securely
into place. ( )
Pre-use Battery Check
 Press the POWER button (Fig. 1, #5) on the back of the King Vision Display.
 The display should turn ON immediately. Note: No image will be displayed on the screen without
an attached video adapter.
o The GREEN LED battery indicator light (Fig. 1, #6) indicates the display is ready for use.
Important: If the LED battery indicator light is FLASHING RED, the batteries must be replaced as soon
as possible as a limited amount of battery life remains.
 The display can be turned “OFF” manually by pressing and holding the POWER button. If a King
Vision Video Adapter is not attached to the display, it will automatically turn off in approximately
20 seconds.
Step by Step Instructions
Important: The King Vision Display must be “OFF” before attaching the video adapter, otherwise the
video image will become distorted. If this happens, simply turn the display “OFF,” attach the video
adapter, then turn the display back “ON”.
STEP 1 –Preparing the King Vision aBlade Video Laryngoscope (the display, video adapter, and blade
combination) for use:
 Choose the size of blade needed based on patient age, size and other relevant factors
 Choose blade type (standard or channeled) based on preferred tube delivery technique. Only
applies to blade sizes 2 and 3.
 Connect the appropriate size of video adapter needed based on intended blade size
 Connect the video adapter to the display. Note that the front and back of the display and video
adapter are color-coded to facilitate proper orientation. Fully insert the unlocked video adapter
onto the stem of the display. Slide locking mechanism up until the yellow stripe is no longer
visible. It should click/snap securely into place.
 Power on and verify imaging function. With the video adapter locked onto the display, press the
POWER button (Fig. 1, #5) on the back of the King Vision Display and confirm that the display
shows a moving image. If the screen remains blank, replace the batteries. If the display powers on
but does not show a functional moving image, power off and verify that the video adapter is
properly connected before powering on again. If a functional image still cannot be obtained,
replace the video adapter or the display.
 Insert the blade over the video adapter. Slide the blade over the video adapter (only goes
together one way). Listen for a “click” to signify that the blade is fully engaged onto the video
adapter. Confirm that a functional moving image still exists.
Using The King Vision Channeled aBlade
Using The King Vision Standard aBlade
The size #3 and 2 channeled blades are designed
to be used with standard ETT sizes. See section on
The size #3, 2 and 1 standard blades are used when
integral guidance of the ETT is not indicated.
In this case, a stylet will likely be necessary.

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blade specifications for tube size
recommendations.
No stylet is needed.
Lubricate the ETT, the guiding channel of the
channeled blade and the distal tip of the blade
using a water soluble lubricant. Take care to avoid
covering the distal window of the blade with
lubricant.
The ETT may be preloaded into the guiding channel
with its distal tip aligned with the end of the
channel. Note that the ETT tip should not be
evident on the screen when loaded properly.
Alternatively, the ETT can be inserted into the
channel after the blade has been inserted into the
mouth and the vocal cords have been visualized.
Lubricate the distal tip of the standard blade using a
water soluble lubricant. Take care to avoid covering
the distal window of the blade with lubricant.
The ETT and stylet should be lubricated and the
stylet pre-loaded into the ETT in the same manner
as with other intubations where a stylet is used.
User tip: Shaping the ETT with a pre-loaded stylet to
match the blade curvature may be helpful.
IMPORTANT: If the LED Battery indicator light (Fig. 1, #6) in the upper left hand corner of the King Vision
Display is FLASHING RED, the battery life remaining is limited and the batteries should be replaced as
soon as possible.
Step 2 –Insertion of aBlade into the Mouth
 Open the patient’s mouth using standard technique.
 In the presence of excessive secretions/blood, suction the patient’s airway prior to introducing the
blade into the mouth.
 Insert the blade into the mouth following the midline. Take care to avoid pushing the tongue
towards the larynx.
 As the blade is advanced into the oropharynx, use an anterior approach toward the base of the
tongue. Watch for the epiglottis and direct the blade tip towards the vallecula to facilitate
visualization of the glottis on the display’s video screen. The aBlade tip can be placed in the
vallecula like a Macintosh blade or can be used to lift the epiglottis like a Miller blade. For best
results, center the vocal cords in the middle of the display’s video screen.
 If the distal window (Fig. 1, #10) becomes obstructed (e.g., blood/secretions), remove the blade
from the patient’s mouth and clear the lens.
 Avoid putting pressure on the teeth with the King Vision Video Laryngoscope.
STEP 3 –ETT Insertion
Advance the ETT (Channeled aBlade)
Insert the ETT/Stylet (Standard aBlade)
After you can see the vocal cords in the center of
the King Vision Display, advance the ETT slowly
and watch for the cuff to pass through the vocal
cords. Note that minor manipulation of the blade
After you can see the vocal cords on the King
Vision Display, insert the ETT with pre-loaded
stylet into the mouth using a lateral approach.
Once the ETT tip has reached the posterior

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may be needed to align the ETT tip with the vocal
cords.
pharynx, manipulate the ETT to direct its tip
toward the vocal cords. Advance ETT tip just
through the cords then retract the stylet prior to
advancing the ETT into position in the trachea with
the cuff below the cords. Fully remove the stylet.
User Tips for ETT Advancement into the Trachea
The most common issue associated with ETT placement with any video laryngoscope is that the blade tip
has been advanced too far; there may be a good close-up image of the vocal cords, but the ETT cannot be
advanced because the blade/camera is obstructing ETT passage. To address this:
 Follow the anterior surface of the tongue and place the blade tip in the vallecula or,
 If too close to the vocal cords, withdraw the blade slightly to obtain a more panoramic view and
gently lift in an anterior direction prior to attempting to advance the ETT.
Other Tips:
 If the ETT tip is deflected off to the right toward the right aryepiglottic fold or arytenoid cartilage,
twist the ETT counterclockwise 90° to deflect left toward the laryngeal vestibule.
 Use Parker ETT to assist in centering the bevel to enter the laryngeal vestibule.
 With the channeled blade, manipulate the handle to direct the ETT tip toward the laryngeal
vestibule (usually toward the left), then return to midline to advance through the vocal cords.
 With the standard blade, adjust the ETT/stylet curve to match the blade curvature. For a more
anterior larynx, a sharper bend may be appropriate.
 With the standard blade, a retromolar approach with the ETT may facilitate intubation and may
reduce the need to form the ETT/stylet with a sharper bend.
STEP 4 –Blade Removal
Removing The King Vision Channeled aBlade
Removing The King Vision Standard aBlade
Stabilize/hold the ETT laterally and remove the
King Vision Video Laryngoscope from the mouth
by rotating the handle toward the patient’s chest.
As the blade exits the mouth, the ETT should easily
separate from the flexible lateral opening of the
channel.
Stabilize/hold the ETT laterally and remove the
King Vision Video Laryngoscope from the mouth
by rotating the handle toward the patient’s chest.
 Turn off the display by pressing and holding the POWER button (Fig. 1, #5).
Note: Always confirm placement of the endotracheal tube even after visual intubation has been
performed.
STEP 5 –Separation and Disposition of the King Vision Components After Use:
After the procedure is complete, separate the display and video adapter from the blade. Dispose of the
blade following local protocol and clean/disinfect the display and video adapter.
Note: Do not dispose of the King Vision Display or Video Adapter!

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CLEANING and DISINFECTING of the Reusable King Vision Display and Video Adapter
CAUTION:
 Do not submerge the King Vision Display in any liquid as this can damage the display.
 Do not reprocess any device suspected of being exposed to Creutzfeldt-Jakob Disease (CJD) or
variants.
The King Vision Display and Video Adapter are designed for easy cleaning and disinfection. The surfaces of
the display and video adapter are specifically designed to allow proper cleaning without the need for any
specialized equipment or supplies.
The King Vision Display and Video Adapter are intended to have minimal direct patient contact during
normal use.
CLEANING STEPS
Display and Video Adapter:
If the display or video adapter is visibly soiled or contamination is suspected, follow the cleaning steps
outlined below:
 To prevent liquid from entering the King Vision Display, orient the device with the video screen
above the battery compartment (upright/vertical orientation).
 Prepare an enzymatic cleaning solution such as ENZOL (Cidezyme®) in accordance with the
manufacturer’s instructions. Clean the entire outer surface of the display and video adapter with
wipes or gauze that have been moistened (not dripping wet) with the cleaning solution. A cotton
swab may be used to clean the crevices of the purple sealing gasket and the ON / OFF button. This
cleaning step should last at least 2 minutes. After 2 minutes, replace wipe or gauze and repeat for
an additional 2 minutes or until all visible soil has been removed.
o If the video-output connection (Fig. 1, #7) was used, be sure to clean the video port cover
and cable.
 Remove the video adapter (Fig. 1, #2, 14) and clean the display stem, taking care to avoid the
batteries and their contacts, and clean the top of the video adapter cup inside and out to a depth
of about 2cm.
 After cleaning, remove any residue with a damp wipe or gauze.
 Use a dry wipe/gauze to remove water or allow the device to air dry.
 Clean camera head with an alcohol wipe or alcohol moistened gauze if you notice the image is not
clear.
DISINFECTION STEPS
Display and Video Adapter:
To disinfect, follow the steps listed below:
 Reminder: During the disinfection process, orient the display and video adapter with the video
screen above the battery compartment (upright/vertical orientation). Do not submerge the
display or video adapter.
 Using a fresh Super Sani-Cloth wipe, disinfect the display and video adapter for a minimum of 10
minutes, replacing the wipe every 2 minutes.
o Before removing the video adapter from the display, wipe the outside of the display and
video adapter with a fresh Super Sani-Cloth. Ensure all hard to reach areas are thoroughly
wetted with the disinfectant.

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o During the minimum 10 minute disinfection, wipe again the outer surfaces of the display
and video adapter using a fresh Super Sani-Cloth wipe, paying careful attention to the
on/off button, purple gasket, and slider crevices.
o During the minimum 10 minute disinfection, remove the video adapter and wipe the
display stem and the video adapter. Ensure that the outer ledges on either side of the
battery compartment are thoroughly disinfected, taking care to avoid the batteries and
their contacts. Wipe along the bottom of the purple gasket and the top of the video
adapter cup and inside rim. Concentrate on the inside rim of the battery compartment
and inside the video adapter cup out to a depth of about 2 cm. NOTE: Take care to avoid
getting fluid inside the opening at the bottom of the battery compartment.
o If the video-out port (Fig. 1, #7) was used, be sure to disinfect the video port cover and
cable.
 Allow the video adapter to thoroughly air dry.
 After the video adapter is dry, use sterile gauze moistened with sterile water to thoroughly wipe
the display stem, the outer ledges on either side of the battery compartment, the bottom of the
purple gasket and the top of the video adapter cup and inside rim until no evidence of disinfectant
remains.
 Allow the articles to air dry completely.
 After the articles are dry, reconnect the video adapter to the display to close the battery
compartment.
 Use sterile gauze moistened with sterile water to thoroughly wipe the display and attached video
adapter until no evidence of disinfectant remains.
 Allow the articles to air dry completely.
 Clean camera head with an alcohol wipe or alcohol moistened gauze if you notice the image is not
clear.
 Store the King Vision Display and Video Adapter in the supplied storage case or other similar clean
pouch, bag or tray to protect from the environment until it is used again.
Note: The King Vision Display and Video Adapter materials are also compatible with 70% isopropyl alcohol,
Cidex®, Cidex Plus® or Cidex OPA®. When using these disinfectants, follow the disinfectant manufacturer’s
instructions for proper contact conditions and time of exposure. Do not submerge the display. Use
wipes/gauze to apply the disinfectant to the surface of the King Vision Display and Video Adapter for the
time required. Use wipes/gauze moistened with sterile water to remove residue and allow to air dry after
disinfection.
Note:
Use proper cleaning and disinfection technique described above. Do not autoclave, immerse this device in
any liquid or expose to ETO or any other sterilization method. These actions will damage the King Vision
Display and Video Adapter and void the warranty.
Product Identification PART NUMBERS
Display and Video Adapter:
KVIS01VA34 1 each –King Vision Display
1 each –King Vision Size 3/4 Video Adapter
1 each –Protective Case for the Display
3 each –AAA Batteries
KVIS01VA1234 1 each –King Vision Display
1 each –King Vision Size 3/4 Video Adapter
1 each –King Vision Size 1/2 Video Adapter
1 each –Protective Case for the Display
3 each –AAA Batteries
aBlade Kit: