What is direct and indirect laryngoscopy?

Direct laryngoscopy is the method currently used for tracheal intubation in children. It occasionally offers unexpectedly poor laryngeal views. Indirect laryngoscopy involves visualizing the vocal cords by means other than obtaining a direct sight, with the potential to improve outcomes.

Which laryngoscope is most commonly used?

curved Macintosh blade
The most common laryngoscope blade used for intubation in adults is the curved Macintosh blade (Figure 34-4). This is inserted into the right side of the mouth to displace the tongue laterally. The tip of the blade sits in the vallecula and is lifted forward to elevate the epiglottis and expose the laryngeal inlet.

What is a laryngoscopy used for?

This test can be used to look for the causes of symptoms in the throat or voice box (such as trouble swallowing or breathing, voice changes, bad breath, or a cough or throat pain that won’t go away). Laryngoscopy can also be used to get a better look at an abnormal area seen on an imaging test (such as a CT scan).

What is an indirect laryngoscopy?

The simplest form of laryngeal examination is called “indirect laryngoscopy”. The examiner can place a small mirror in the back of the throat and angle it down towards the larynx. Light can be reflected downward and the larynx can be seen in the mirror.

What are two types of laryngoscope blades?

The laryngoscope blade’s design has many forms, and the two most commonly used blades are the Macintosh and Miller blades, which are curved and straight, respectively. The Macintosh blade is easier to operate, while the Miller blade provides a better view of the vocal cords.

Why is it called indirect laryngoscopy?

Indirect laryngoscopy refers to visualization of the larynx with the patient sitting in a chair, by using a mirror, fiberscope, videoendoscope, or laryngeal telescope more in the manner of a perisocope that “looks around the corner” – in this case, the base of the tongue.

What is laryngoscope and its types?

Laryngoscopes are designed for visualization of the vocal cords and for placement of the ETT into the trachea under direct vision. The two main types are the curved Macintosh blade and the straight blade (i.e., Miller with a curved tip and Wisconsin or Foregger with a straight tip).

What is a Macintosh laryngoscope?

The Macintosh laryngoscope has a curved blade which allows exposure of the larynx by positioning the tip in the vallecula, anterior to the epiglottis, lifting it out of view. Macintosh originally designed the laryngoscope to facilitate intubation in unparalyzed patients.

Why is a straight laryngoscope blade recommended for intubating a child?

The straight blade also has the advantage of facilitating the Jackson intubating technique of directly elevating the epiglottis rather than the traditional method of indirectly lifting the epiglottis with the tip of the curved blade placed in the vallecula.

Who is the father of laryngoscopy?

2. Dr. Benjamin Guy Babington, inventor of the laryngoscope. Babington presented his laryngoscope to the Hunterian Society in 1829, and published his report in The London Medical Gazette, Volume 3, page 555, London, 1829.

What is Magill blade?

Ivan Whiteside Magill (1888-1986). Irish-born anaesthetist, responsible for much of the innovation and development of modern anaesthesia. Helped found the Association of Anaesthetists and professional exams in anaesthesia. The blade is U-shaped in cross section. It is the most commonly used straight blade.

When do you use McCoy blade?

McCoy laryngoscope is used in patients when difficulty in elevating epiglottis is encountered and activation of blade tip elevates the epiglottis and visualization of vocal cords.

When do you use a curved laryngoscope?

Direct laryngoscopy depends on being able to bring the 3 axes of the airway into alignment to see the larynx. Curved blades are commonly used, especially by beginners because they are more forgiving of less than optimal placement and provide more room to pass the tube.

What is a Wisconsin blade?

The Wisconsin blade, designed after a laryngoscope used by University of Wisconsin anesthesiologists at the Wisconsin General Hospital in Madison, is a straight blade with a very modest curve at the end of its slightly wide tip. It also has a relatively large semicircular cross-section.

What is the sniffing position?

THE sniffing neck position, defined as neck flexion with upper cervical extension, is a traditionally recommended head and neck position for induction of general anesthesia unless contraindicated.

What are Mcgill forceps used for?

Magill forceps were first described by Magill in 1920[3], and they are used as an aid for nasotracheal intubation as well as to remove foreign bodies.