What is the Turbo® O₂ Cap?

The Turbo® O₂ Cap is a non-sterile airway accessory designed to support oxygenation during difficult or urgent intubations. It attaches to an endotracheal tube (size 5.5 mm–9.0 mm) and channels 100% oxygen (15 L/min) directly to the area near the vocal cords*. It offers a simple, intuitive, and affordable method to address oxygen desaturation during airway management.

* When the endotracheal tube is positioned properly within the hypopharynx near the glottic opening.

During emergent intubations, oxygen saturation can fall rapidly, particularly after rapid sequence intubation (RSI) when patients are chemically paralyzed [1]. Current standard practice often includes the use of nasal cannulas for supplemental oxygenation; however, studies have shown that oxygen concentrations measured 10 cm from the nasal prongs rarely exceed 23.5%, even at high flow rates [2]. Given that the distance from the nose to the vocal cords averages 5–7 cm, effective oxygen delivery is suspected to be limited, especially when patients are chemically paralyzed. Turbo® O₂ Cap was developed after the company’s CEO witnessed another near-critical airway case in which a surgical cricothyrotomy was nearly required following repeated failed intubation attempts, highlighting the urgent need for a better solution.

[1] Bodily, D.A., et al., “Incidence and Duration of Continuously Measured Oxygen Desaturation During Emergency Department Rapid Sequence Intubation,” Annals of Emergency Medicine, Vol. 67, No. 3, 2016, pp. 389–395.
https://doi.org/10.1016/j.annemergmed.2015.06.006

[2] Lumb, A.B., and Slinger, P., “Hypoxaemia in the Postoperative Period: Oxygen Physiology and Monitoring,” Anaesthesia, Vol. 63, No. 5, 2008, pp. 564–569.
https://doi.org/10.1111/j.1365-2044.2008.05820.x

In a large porcine model simulating rapid sequence intubation, subjects were sedated and paralyzed, and a laryngoscope was used to elevate the jaw. An endotracheal tube was positioned in the hypopharynx, to the side of the vocal cords without advancing through them, simulating a difficult intubation attempt. In the control group, no oxygen was delivered; oxygen saturation dropped below 75% within one minute. In the test group, using the Turbo® O₂ Cap delivering 100% oxygen at 15 L/min through the ET tube and into the hypopharyngeal space near the glottis, oxygen saturations rose to 99% and remained stable for 15 minutes despite complete paralysis and absence of respiratory movement. This outcome is attributed to passive diffusion, with high-concentration oxygen positioned immediately in front of the vocal cords and lower oxygen concentration present beyond the cords within the lungs, creating a favorable diffusion gradient. While these findings come from animal model**, human clinical studies are underway, and the Turbo® O₂ Cap is now commercially available in the United States.

** Results observed in a human-analog (porcine) research model when positioned appropriately.

Some medical providers insert the laryngoscope into the mouth and then follow by advancing the endotracheal tube alongside it into the oropharynx, preparing to intubate once the vocal cords are visualized. Others prefer to withhold the endotracheal tube outside the mouth until the laryngoscope is positioned, bringing the tube into the airway only once the cords are in view. SharpMed, LLC does not instruct or direct how medical providers should perform intubations. In general, as long as the ET tube is positioned properly within the hypopharynx near the glottic opening a provider may still obtain the potential benefit of enhanced oxygenation***.

*** SharpMed, LLC does not instruct medical providers how to practice medicine, including intubation techniques. Providers should use the Turbo® O₂ Cap according to the Instructions for Use (IFU) and established standards of good clinical practice. The Turbo® O₂ Cap delivering 100% oxygen can deliver oxygen near the glottic inlet during apnea  and support oxygenation during difficult intubations only if the device is properly positioned in the hypopharynx near the glottic opening.

The Turbo® O₂ Cap can remain in place during suctioning. It continues to deliver oxygen while you clear secretions.

The device was designed to help minimize support oxygenation no matter what the starting point is. Even with preoxygenation to 94%, oxygen levels can drop quickly during intubation, and the Turbo® O₂ Cap continues delivering oxygen throughout the attempt.

No, the conforming valve is strictly for the insertion of a stylet and is not intended to introduce other tools or medication.

Yes. It should connect to standard oxygen extension tubing with a female adaptor on both ends of the tubing.

While there has been no direct study comparing nasal cannulas to the Turbo® O₂ Cap, the big difference is the ability of the Turbo O₂ Cap to deliver oxygen much closer to the vocal cords.

15 L/min.

Yes. The Turbo® O₂ Cap is a U.S. Class I medical device.

It is suitable for both urgent and elective intubations, as you never know for sure when a difficult airway may arise.

Preoxygenation fills the lungs before apnea. The Turbo® O₂ Cap delivers oxygen during apnea.

Yes. Please refer to the Instructions for Use (IFU) document for full details. Turbo® O₂ Cap IFU

No. Single-use only.

Inner diameter (I.D.) 5.5 mm to 9.0 mm.

Refer to Table 1 in the IFU for specific pairings. Turbo® O₂ Cap IFU

No, the conforming valve is strictly for the insertion of a stylet and is not intended to introduce other tools or medication.

Ideally as soon as intubation is successful and the ET tube balloon is inflated.

We do not believe the Turbo adds significant gastric inflation risk, based on a few key factors:
– With the laryngoscope in place, the airway is open, and excess gas escapes out the mouth
– In our animal lab, stomach x-rays taken before and after 16-minute simulated intubations showed minimal to no gas inflation

That said, aspiration is a real and inherent risk of emergency intubation — and that risk exists regardless of our device. All standard precautions to prevent aspiration should always be used.