Trapeze Artist
Lightwand Title

Lightwand deviceDescription:

Lighted stylettes rely upon transillumination of the anterior neck tissues to demonstrate laryngeal placement. A well-circumscribed glow indicates tracheal intubation, whereas a diffuse glow is seen with esophageal placement.

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Indications:

  • Endotracheal intubation
  • Patients with limited mouth opening, reduced neck movement
  • Difficult or failed intubation
  • Bloodied airway


Contraindications:

  • Pharyngeal masses
  • Anatomic abnormality of upper airway

Advantages:

  • Less stimulating than direct laryngoscopy
  • Does not require visualization of the larynx
  • Allows nasal intubation
  • Portable and inexpensive



Disadvantages:

  • Blind technique, which may cause trauma/burns to tissue
  • Difficult to view in dark-skinned patient or scarred tissue
  • May require a darkened environment

Special Features:

  • May use to check ETT position
  • Use flexible Trachlight™ stylette with LMA Fastrach ™


Tips for Success:

  • Maintain proper head position, stay in midline
  • Perform "jaw-lift" to elevate epiglottis
  • Practice, practice, practice!

Currently available devices include:

  • Trachlight™ (Laerdal)
  • Vital Light™ (Vital Signs)
  • Trachlite™ (Rusch)
  • Surch-Lite™ (Aaron Medical Industries, Inc.)

References:

  1. Stewart RD, Larosse A, Kaplan RM, et al. "Correct Positioning of an Endotracheal Tube Using a Flexible Lighted Stylette." Crit Care Med 18:97, 1990.

  2. Hung OR, Pytka S, Murphy MF. "Clinical Trial of a New Lightwand to Intubate the Trachea." Anesthesiology 1995.

  3. Davis L, Cook-Sather S, Schreiner MS. "Lighted Stylette Intubation: A Review." Anesth Analg 90:745, 2000.

  4. University of Florida College of Medicine, Department of Anesthesiology website.
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Lightwand
Intubation