Video laryngoscopy: Difference between revisions
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==Indications== | ==Indications== | ||
* | *Any patient requiring [[intubation]] | ||
**Particularly useful in patients with known or anticipated difficult intubation | |||
==Contraindications== | ==Contraindications== |
Revision as of 22:11, 28 November 2020
Overview
- Two principal versions are the C-MAC and the Glidescope
- Glidescope first introduced in 2001, features a hyperangulated blade
- CMAC features a Macintosh or standard geometry blade
- Today, both CMAC and Glidescope systems offer hyperangulated and standard geometry blades
- Increasingly utilized in emergency airway management
Indications
- Any patient requiring intubation
- Particularly useful in patients with known or anticipated difficult intubation
Contraindications
- Relative:
- Blood or emesis in airway
- Foreign body removal
Equipment Needed
- Video laryngoscope
- Rigid stylet if hyperangulated blade is used
- All other equipment necessary for endotracheal intubation
Procedure
- Hyperangulated Video Laryngoscope
- Patient ideally in neutral spine position (as opposed to "sniffing" position for direct laryngoscopy)
- After induction, use right hand to "scissor" mouth open
- Place hyperangulated blade midline and slowly advance with progressive identification of airway landmarks
- Advance blade into vallecula
- When cords fill entire screen (Cormack-Lehane Grade I), slightly retract laryngoscopy so that cords only occupy upper 1/3 of screen (CL Grade II, allows for passage of ETT with rigid stylet)
- If intubation is attempted with the best view possible, operators often have difficulty advancing the tube around the tongue and hypopharyngeal soft tissues
- Standard Geometry Video Laryngoscope
- Same technique utilized with direct laryngoscopy
- Can either visualize directly or utilize video screen for tube delivery
Complications
- Risk of equipment failure with hyperangulated laryngoscope (unable to obtain direct view if screen fails)
- Risk of camera contamination with blood or emesis in airway
- Foreign body removal with hyperangulated laryngoscope less successful than with Macintosh laryngoscope [1]
See Also
Airway Pages
- Pre-intubation
- Induction
- Intubation
- Surgical airways
- Post-intubation
References
- ↑ Je, S. M., Kim, M. J., Chung, S. P., & Chung, H. S. (2012). Comparison of GlideScope® versus Macintosh laryngoscope for the removal of a hypopharyngeal foreign body: A randomized cross-over cadaver study. Resuscitation, 83(10), 1277–1280.