 Description:
These
devices generally consist of an anatomically shaped blade, fiberoptic
bundles and light source. They allow for visualization of the
airway without manipulation of the head and neck.
Indications:
- Endotracheal
intubation
- Patients
with limited mouth opening/reduced neck movement
- Difficult
airways
Contraindications:
- Lack
of skill
- Lack
of functioning equipment
Advantages:
- Allows
for visualization of the larynx with little or no neck movement
and limited mouth opening
- May
overcome difficult view
- Generally
sturdy and durable instruments
Disadvantages:
- Requires
skill, some devices need light source
- Often
best performed in the awake patient
- Wu
scope™ requires considerable mouth opening
Special
Features:
- Use
to visualize larynx without stress
- May
perform jet ventilation via forceps channel
Tips for Success:
-
Neutral head position
-
Use of a flexible guide or blade extender
- Practice,
practice, practice!
Currently
available devices include:
- Bullard™
(Circon)
- Upsher™
(Mercury Medical)
- Wu™
(Pentax)
References:
-
Cooper SD, Benumof JL, Ozaki GT. "Evaluation of the Bullard
Laryngoscope with the New Intubating Stylette: Comparison with
Conventional Laryngoscopy." Anesth Analg 79:965,
1994.
-
Cohn
AI, Zornow MH. "Awake Intubation in Patients with Cervical
Spine Disease: A Comparison of the Bullard Laryngoscope and
the Fiberoptic Bronchoscope." Anesth Analg 81:1283,
1995.
-
Watts
DJ, Gelb AW, Bach DB, Pelz DM. "Comparison of the Bullard
and Macintosh Laryngoscopes for Endotracheal Intubation in Patients
with a Potential Cervical Spine Injury." Anesthesiology
87:1335, 1997.
-
University
of Florida College of Medicine, Department
of Anesthesiology website.
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