What's New In  |   June 2015
Recent Developments in Airway Management
Author Affiliations
  • Uday Jain, M.D., Ph.D.
    Committee on Newsletter Abstract Review Subcommittee on Equipment, Monitoring and Engineering Technology
  • Olga Kaslow, M.D., Ph.D.
    Committee on Trauma and Emergency Preparedness
  • Arman Dagal, M.D., FRCA
    Committee on Trauma and Emergency Preparedness
Article Information
Airway Management / Gastrointestinal and Hepatic Systems / Respiratory System / What's New In
What's New In   |   June 2015
Recent Developments in Airway Management
ASA Monitor 06 2015, Vol.79, 66-68.
ASA Monitor 06 2015, Vol.79, 66-68.
Proliferation of Video Devices: Recently there has been a substantial increase in the number of commercially available video devices for facilitating intubation. Their utilization is now widespread. These include video laryngoscopes (VLs) and video stylets that are placed inside endotracheal tubes (ETTs). Flexible bronchoscopes that have video cameras at the tip instead of optical fibers in them have also become available. Some of the VL blades have an integrated channel (VLc) for passage of an ETT exchange catheter, or fiberoptic bronchoscope (FOB), or ETT.
As the VL camera is located close to larynx, visualization of an anterior larynx is substantially better with VL than with direct laryngoscopy (DL).1  Failure to visualize can be corrected by adjusting the position of the VL blade in the pharynx (and by external manipulation of the larynx). Unlike during DL, improved visualization of larynx on VL does not correlate with ease of intubation. Attempted intubation with VL with a non-channeled blade occasionally fails despite visualization of the larynx.1  This usually happens because of an inadequate pharyngeal opening in which to maneuver the ETT. Because the larynx can be viewed without substantial retraction by VL, the intubationist does not retract as much as during DL, limiting pharyngeal opening. The VL blade inserted in the pharynx is usually more voluminous than the DL blade, reducing the opening for ETT. Greater angulation of the VL blade may only slightly improve visualization but may substantially increase difficulty of intubation.
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