This Voice is Our Opportunity

…we should express our gratitude for the small and simple things like the scent of the rain, the taste of your favorite food, or the sound of a loved one's voice. -Joseph B Wirthlin


Just before dawn, Doctor Blake Simpson takes his first well deserved swallow of black coffee and thinks about the procedure he is about to perform. He doesn’t look forward to any procedure, but this one is especially distressing. He anticipates the uncontrolled coughing, accompanied by reflexive gagging that his patient will experience. It doesn’t help that this patient is someone he has known for years. This patient is John Houston, a friend, and he has suffered through 60 of these traumatic examinations.

Doctor Simpson remembers the excitement in John’s voice when he called three weeks earlier with the news. With help from The Realtime Group,, an engineering design and development company in Dallas, John built a prototype that would revolutionize the laryngeal exam. Would the prototype work as well as they both hoped it would?

There it was, a strange looking contraption with hoses and wires perched awkwardly on a wheeled cart. And there was John, perched on the chair beside it, a look of childish expectation on his face. Dr. Blake began the exam as usual. Immediately he saw something was different. The ineffective, gag causing drip of Lidocaine was replaced with the muscle soothing continual vapor emitting from the odd looking device. Gone was the coughing and pain, present was an exam that was painless, comfortable and thorough. Thoughts and emotions raced though the doc’s head. He envisioned the previously pained faces of his patients, replaced with joy by this new machine. With relief he blurted out “That’s Bad Ass!” …And it is.


Prep Air is a medical device that eliminates the reflex gagging and coughing caused by inhaling liquid-lidocaine anesthesia during examinations of the larynx. Prep Air delivers lidocaine as a vapor that’s quickly absorbed by throat tissue, resulting in a safer, more comfortable patient experience.


Our larynx – or “voice box” – enables us to breathe, produce sounds, and prevent food from being inhaled into our lungs.

Medical examination of the larynx (laryngoscopy) involves forcing a 5mm tube through a patient’s nose and down the throat so the larynx can be viewed with a fiber-optic camera – a procedure that’s extremely stressful, uncomfortable, and potentially damaging to throat tissue.

Realtime took the vision of Prep Air inventor John Houston from a sketch to final product within six months, creating a device that works with existing laryngoscopic instruments to deliver a radically better patient experience.

If a minimally invasive procedure is poorly tolerated by patients we truly can't advance medicine, no matter how sophisticated the technology. With DUALAMS we now have the means to make office visits comfortable, something that was impossible till now. -Dr. Blake Simpson


Prep Air not only makes throat exams far more comfortable for patients, it also shortens exam time, eliminates the need for multiple attempts, and enables doctors to focus on gathering more reliable clinical information.

No other laryngoscopic devices exist that transform lidocaine from liquid to vapor in real time, making Prep Air a true innovation.

Realtime’s full spectrum of product-design specialties and experience was leveraged to ensure product functionality and rapid time-to-market.

The result is an affordable, producible device that will qualify for insurance reimbursement and has high FDA-approval potential.

The greatest science in the world, in heaven and on earth, is love. - Mother Theresa


Realtime, the product design team of Prep Air is passionate about engineering solutions that enhance people’s lives. With its ability to improve the experience and outcomes for medical patients, the Prep Air concept invoked Realtime’s dedication to that mission. Currently, doctors sometimes forego laryngoscopic exams when they believe their patient won’t tolerate the procedure, which then forces them to rely on alternative – and often less-reliable — methods. By improving the patient experience, Prep Air will increase the frequency that today’s most-reliable laryngoscopic procedure is chosen.


Realtime’s Prep Air design was hailed as a top medical innovation at the 2017 Fall Voice Conference, an annual event focused on the clinical care of patients with voice-related difficulties. Since then, over 10 medical institutions and university systems have volunteered for clinical trial testing. The prototypes have been rigorously tested at The University of Texas Health Science Center for the last 14 months and have performed flawlessly. Prep Air’s 510K filing for the FDA is on-track for Q4 2017, and is expected to be awarded within days. It is also on-track for initial availability in Q1 2018, with full-rate production by mid-2018.