scholarly journals A Laryngoscope for Obstetrical Use an Obstetrical Laryngoscope

1977 ◽  
Vol 5 (3) ◽  
pp. 265-266 ◽  
Author(s):  
John Kessell
Keyword(s):  
Tracheal Intubation ◽  
Cricoid Pressure ◽  
Macintosh Laryngoscope ◽  
The Right

Rapid tracheal intubation, using the standard Macintosh laryngoscope, can be hindered in obstetrical patients by the handle of the laryngoscope hitting the patient's engorged breasts and the hand of the assistant applying cricoid pressure. To overcome these difficulties a variation of the laryngoscope is described. The right angle of the blade to the handle is opened by a further 20°.

Comparison of the Bullard and Macintosh Laryngoscopes for Endotracheal Intubation of Patients with a Potential Cervical Spine Injury 

1997 ◽  
Vol 87 (6) ◽  
pp. 1335-1342 ◽  
Author(s):  
Andrew D. J. Watts ◽  
Adrian W. Gelb ◽  
David B. Bach ◽  
David M. Pelz
Keyword(s):  
Cervical Spine ◽  
General Anesthesia ◽  
Endotracheal Intubation ◽  
Cervical Spine Injury ◽  
Cricoid Pressure ◽  
Macintosh Laryngoscope ◽  
Spine Injury ◽  
Neck Extension ◽  
Bullard Laryngoscope ◽  
Spine Movement

Background In the emergency trauma situation, in-line stabilization (ILS) of the cervical spine is used to reduce head and neck extension during laryngoscopy. The Bullard laryngoscope may result in less cervical spine movement than the Macintosh laryngoscope. The aim of this study was to compare cervical spine extension (measured radiographically) and time to intubation with the Bullard and Macintosh laryngoscopes during a simulated emergency with cervical spine precautions taken. Methods Twenty-nine patients requiring general anesthesia and endotracheal intubation were studied. Patients were placed on a rigid board and anesthesia was induced. Laryngoscopy was performed on four occasions: with the Bullard and Macintosh laryngoscopes both with and without manual ILS. Cricoid pressure was applied with ILS. To determine cervical spine extension, radiographs were exposed before and during laryngoscopy. Times to intubation and grade view of the larynx were also compared. Results Cervical spine extension (occiput-C5) was greatest with the Macintosh laryngoscope (25.9 degrees +/- 2.8 degrees). Extension was reduced when using the Macintosh laryngoscope with ILS (12.9 +/- 2.1 degrees) and the Bullard laryngoscope without stabilization (12.6 +/- 1.8 degrees; P < 0.05). Times to intubation were similar for the Macintosh laryngoscope with ILS (20.3 +/- 12.8 s) and for the Bullard without ILS (25.6 +/- 10.4 s). Manual ILS with the Bullard laryngoscope results in further reduction in cervical spine extension (5.6 +/- 1.5 degrees) but prolongs time to intubation (40.3 +/- 19.5 s; P < 0.05). Conclusions Cervical spine extension and time to intubation are similar for the Macintosh laryngoscope with ILS and the Bullard laryngoscope without ILS. However, time to intubation is significantly prolonged when the Bullard laryngoscope is used in a simulated emergency with cervical spine precautions taken. This suggests that the Bullard laryngoscope may be a useful adjunct to intubation of patients with potential cervical spine injury when time to intubation is not critical.

Cricoid pressure and the pressor response to tracheal intubation

Anaesthesia ◽  
1988 ◽  
Vol 43 (9) ◽  
pp. 788-791 ◽  
Author(s):  
P. Mills ◽  
T. Poole ◽  
J. Curran
Keyword(s):  
Tracheal Intubation ◽  
Cricoid Pressure ◽  
Pressor Response

scholarly journals Comparison of Direct and Indirect Laryngoscopes in Vomitus and Hematemesis Settings: A Randomized Simulation Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ryosuke Mihara ◽  
Nobuyasu Komasawa ◽  
Sayuri Matsunami ◽  
Toshiaki Minami
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Macintosh Laryngoscope ◽  
Intubation Time ◽  
Direct Laryngoscope ◽  
Mcgrath Mac ◽  
Significant Difference ◽  
Intubation Success ◽  
Intubation Success Rate

Background.Videolaryngoscopes may not be useful in the presence of hematemesis or vomitus. We compared the utility of the Macintosh laryngoscope (McL), which is a direct laryngoscope, with that of the Pentax-AWS Airwayscope (AWS) and McGRATH MAC (McGRATH), which are videolaryngoscopes, in simulated hematemesis and vomitus settings.Methods.Seventeen anesthesiologists with more than 1 year of experience performed tracheal intubation on an adult manikin using McL, AWS, and McGRATH under normal, hematemesis, and vomitus simulations.Results.In the normal setting, the intubation success rate was 100% for all three laryngoscopes. In the hematemesis settings, the intubation success rate differed significantly among the three laryngoscopes (P=0.021). In the vomitus settings, all participants succeeded in tracheal intubation with McL or McGRATH, while five failed in the AWS trial with significant difference (P=0.003). The intubation time did not significantly differ in normal settings, while it was significantly longer in the AWS trial compared to McL or McGRATH trial in the hematemesis or vomitus settings (P<0.001, compared to McL or McGRATH in both settings).Conclusion.The performance of McGRATH and McL can be superior to that of AWS for tracheal intubation in vomitus and hematemesis settings in adults.

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