Direct laryngoscopy

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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

Contraindications

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)

  1. Place patient into sniffing position
  2. Use "scissor" technique with right hand to open mouth
  3. Insert laryngoscope blade into right side of mouth
  4. Slowly advance blade into mouth while performing "tongue sweep"
  5. Identify epiglottis
  6. Advance tip of blade into vallecula
  7. Lift upward and away from operator to expose glottis
  8. 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

External Links

References

  1. 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]]