Through the Cords

Through the Cords, a Salt Lake City-based company is stepping up production and distribution of its intubation device, the Runnels Total Control IntroducerTM (TCI), to meet the urgent need for first-attempt intubation success during the COVID-19 Pandemic. The TCI is uniquely positioned to have a large impact on intubation safety for both providers and patients.
The Runnels TCI is a novel articulating intubating stylet designed to increase first-pass breathing tube placement during video laryngoscopy-assisted intubations. The critical benefit of using the TCI on each intubation is the distance it allows between the patient and the provider during intubation, while facilitating successful introduction of the breathing tube. This feature preserves the viability of the provider population and the health care system through this pandemic and beyond by keeping providers safe from contamination. The innovative and simple intubation tool is designed to reduce intubation complications and mitigates the provider’s exposure to infectious particles.
Prior to the COVID-19 Pandemic, intubations were the third most common medical procedure in the U.S. with more than 30 million performed each year. More than half of failed intubation attempts were due to the inability to direct the endotracheal tube into the trachea, or because of inaccurate depth control. These complications result in compromised patient outcomes, 60 thousand attributable deaths, and an estimated cost of more than $5 billion in increased medical care needed because of first-pass intubation failure.
A look at COVID-19 by the numbers:  According to the Health Affairs Blog, between 40 and 60 percent of, or 100 million Americans will be infected with COVID-19 over an estimated period of 6 to 18 months. Conservatively, some 4.5 million infected individuals will be critically ill and require intubation. This increase in intubations not only exposes the provider population to aerosolization of the virus and risk of infection, but also creates higher risks for intubation complications such as brain injury, cardiac arrest, and death to patients from failed intubation attempts.
Runnels says, “COVID-19 has changed our world. So much of the supply chain for PPE (personal protective equipment ) and what we need to stay safe is unavailable and out of our control as providers. Using the Runnels TCI with intubation will contribute to saving patient lives and keep providers safe. The device is being used on the front lines in Utah, Chicago, New York, and Florida. Intubation is the highest risk procedure we will perform on a COVID-19 infected patient—it is the procedure where the virus can contaminate us. Right now, too many of my colleagues are forced to perform intubation without proper PPE.
“Getting this right is the difference between too many sick providers and the collapse of our medical system or survival. Providers are the system. The number 1 priority needs to be keeping them safe by any means possible as they step up to take care of patients in spite of the risk to themselves due to the lack of PPE. We are launching an awareness campaign to get as many devices into the fight in order to make a difference at this critical turning point in global history. I just feel lucky that our company is in a position to have impact in the fight at this kind of scale.”
Given the current resource-restricted healthcare system, swift, successful intubations result in better patient outcomes, less potential for provider exposure, and reduced stress on the already over-taxed providers. Universal use of the Runnels TCI resolves many of the pressing issues regarding intubation, and the preservation of the limited number of providers qualified to perform intubations.
Dr. Sean T. Runnels, anesthesiologist and associate professor of Anesthesia at the University of Utah founded Through the Cords, a device innovation and manufacturing company focused on next-generation airway tools for use with video laryngoscopes. The company currently manufactures and distributes three products, the Runnels TCI, the Runnels Intuitive Depth BougieTM (IDB), and the Runnels Intuitive Depth ExchangeTM Catheter (IDE). The devices are manufactured in Salt Lake City with all components sourced in the USA.
The Total Control Introducer (TCI) facilitates successful intubation through articulated guidance and mid-trachea depth accuracy. Features include: a) Articulating tip that facilitates precision control for easy maneuvering through the vocal cords and into the trachea; b) Flexible shaft that conforms to the upper airway; c) An intuitive depth control system designed to prevent injury in lower airways by keeping tip safely mid-trachea; d) Packaged for immediate use, detachable handle, no need to preload tube; e) Single use lowers the risk of contaminating other patients.