Healthremedy123.com – When using a laryngoscope for intubation, a surgeon must first know exactly how to perform the procedure. The intubation process can be extremely dangerous, particularly for patients who are awake. The study assessed the success rate of intubation using the GL and McCoy scopes, and included all patients who were intubated. Patients were randomized to either scope during the first attempt or the second. Intubation time was calculated as the sum of all intubation attempts.
How to Insert the Correct Laryngoscope
The patient’s position must be neutral, and the ETT and scope tip must be in the midline. The ETT should be held in the “nook” of the Bullard’s jaw. The laryngoscope/ETT assembly should be advanced as a unit, so as not to distort anatomy. A guard is used on the fiberoptic light source to prevent the scope from being accidentally inserted into the vocal cords. The ETT and the laryngoscope should then be inserted and advanced over the tongue with minimal distending anatomy.
The i-scoop has two major advantages over the other two options. Its curved guiding bar, lateral lenses, and airway-viewing tip facilitate intubation. The i-scoop had the best success rate among the other two techniques. In the study, participants used the i-scoop to intubate a manikin with an airway that was difficult to open. Intubation of patients with difficult airways with the other laryngoscopes was more difficult and required more time.
The i-scoop features an adjustable guiding bar that follows the shape of the airway. Other laryngoscopes featured blades that prevented the necessary viewing angle in difficult airways. Also, the i-scoop’s blade is not as steep as the other models and increased lifting forces can cause harm. One study even used the AirSim Advance Bronchi X intubation simulator to simulate a difficult airway involving an enlarged tongue and a notched epiglottis.
Main Types of Laryngoscope with Different Functions
There are two major types of laryngoscopes: one for adults and one for pediatric patients. One is an adult laryngoscope, which is available in pediatric sizes. The other type is the McCoy laryngoscope. Both are useful tools for intubation, but they differ in their function. In fact, the McCoy laryngoscope has become one of the most widely used in noninvasive tracheal intubations.
A prospective study comparing the Macintosh and the Miller laryngoscopes in the hands of inexperienced users showed that the Macintosh had a superior intubating condition in a normal airway. The Macintosh group also achieved adequate ventilation within three insertion attempts. All intubations performed in the Macintosh group were successful, while all 13 patients in the Miller group failed.
Video Laryngoscope Intubation Recommended for Difficult Airway
Video laryngoscope intubation is recommended for patients with difficult airways. In a recent study, a video laryngoscope was compared to direct laryngoscopy for intubation. Patients underwent elective abdominal surgery were randomly assigned to receive video or direct laryngoscopy. The study used a standardized procedure to measure mouth opening, thyromental distance, sternomental distance, and glottic exposure grade.
The study used a randomized control group design. The same anesthesiologists performed both procedures. The patients were randomly divided into two groups of equal numbers. The nurses then scored the difficulty of intubation using a visual analogue scale, with 0 being very easy and 10 being very difficult. The results showed that the use of a laryngoscope improves the efficiency of intubation.
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