Direct laryngoscopy
Revision as of 01:17, 22 October 2020 by ClaireLewis (talk | contribs)
Overview
- Used to facilitate intubation
- Provides direct line of sight of vocal cords (as opposed to video laryngoscopy)
- Most often utilizes Mac or Miller Blade
Indications
- Patients requiring endotracheal intubation
Contraindications
- Glottic or supraglottic pathology requiring surgical airway interventions
Equipment Needed
- Handle with light source
- Macintosh or Miller Blade
- A Macintosh 3 blade or Miller 2 blade are appropriate for most adults
Procedure (Macintosh Blade)
- Place patient into sniffing position
- Use "scissor" technique with right hand to open mouth
- Insert laryngoscope blade into right side of mouth
- Slowly advance blade into mouth while performing "tongue sweep"
- Identify epiglottis
- Advance tip of blade into vallecula
- Lift upward and away from operator to expose glottis
- If needed, perform bimanual laryngoscopy to optimize Cormack-Lehane view
Complications
- Dental Trauma (minimize risk while lifting blade upward and away from operator)
- Laryngeal Trauma
- Sympathetic nervous system stimulation leading to tachycardia and hypertension
See Also
Airway Pages
- Pre-intubation
- Induction
- Intubation
- Surgical airways
- Post-intubation
External Links
References
- Peterson K, Ginglen JG, Valenzuela FI, et al. Direct Laryngoscopy. [Updated 2020 Mar 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513224/[Category:Procedures]]