Name:
ACA- Hung 4e- Tracheal Intubation Using the GlideScope®
Description:
ACA- Hung 4e- Tracheal Intubation Using the GlideScope®
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/096f1efe-71ae-44ef-8e0d-cfe61db208ba/videoscrubberimages/Scrubber_1.jpg?sv=2019-02-02&sr=c&sig=jdQrghdjy6xcue1YliA11qpbvlKZzi7%2BX0n%2B%2FvsIH44%3D&st=2024-12-21T16%3A18%3A28Z&se=2024-12-21T20%3A23%3A28Z&sp=r
Duration:
T00H04M38S
Embed URL:
https://stream.cadmore.media/player/096f1efe-71ae-44ef-8e0d-cfe61db208ba
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/096f1efe-71ae-44ef-8e0d-cfe61db208ba/Tracheal Intubation Using the GlideScope.mov?sv=2019-02-02&sr=c&sig=h09I35KcgLmik%2FT8kxNVuyqSD7Um9m%2F0XRN9ZjAqrUE%3D&st=2024-12-21T16%3A18%3A28Z&se=2024-12-21T18%3A23%3A28Z&sp=r
Upload Date:
2023-11-24T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
Segment:1 Device.
The GlideScope consists of a plastic, modified Macintosh-type laryngoscope blade with the distal half angled upward approximately 60 degrees. The blade incorporates a video chip and light emitting diodes that provide adjustable illumination and contrast. The video chip is covered by a heated glass window, making it fog resistant.
The video image is conveyed from the laryngoscope blade by a cable to a dedicated LCD video display. The original adult version required an inter-incisor gap of 18 millimeters. A new, lower profile laryngoscope reduces this to 14.5 millimeters and provides a color image. Pediatric, neonatal, and battery powered portable versions are also available.
Segment:2 Preparation.
Malleable stylet loaded into the endotracheal tube is recommended. Prepare the stylet with an adequate amount of lubricant. While various stylet shapes have been described, it is our preference to bend the distal end of the trachael tube and stylet assembly to 60 degrees to facilitate intubation. Similar to trachael intubation using the Bullard laryngoscope, a reverse loading of the tracheal tube onto the stylet that may prevent the tip of the tube from hanging up anteriorly while advancing the tube into the trachea.
An anti-fogging solution is not required. Special positioning of the head and neck of the patient is generally not required.
Segment:3 Technique .
Following appropriate denitrogenation of the patient, the GlideScope should be introduced into the mouth in the midline and maintained in the midline as it is rotated around the tongue. Care should be taken to avoid injury to the lips and teeth during laryngoscope insertion.
The uvula, base of the tongue, and epiglottis should be seen in succession to ensure proper midline orientation. The blade is preferentially introduced into the vallecula. And the glottis can be visualized easily with a gentle lift. The endotrachael tube is inserted through the right corner of the mouth.
The shape of the stylet should permit it to be directed anteriorly toward the larynx. Advance the tube over the stylet it into the glottis by pushing it with the thumb. Secure the tube in place. And remove the stylet. After intubation, the GlideScope should be removed. The tracheal tube placement should be confirmed using end-tidal CO2 and auscultation.
Segment:4 Trouble Shooting.
Occasionally, despite excellent laryngeal exposure, the tip of the endotracheal tube cannot be advanced through the glottis. After confirming that the angle of the GlideScope and depth of insertion are appropriate, external laryngeal pressure may bring the glottis to the tube, although this is rarely necessary.
The shape of the stylet can also be altered. Alternatively, under visual control, a coude-tipped Eschmann tracheal introducer can be introduced into the trachea, following which the endotracheal tube is visually advanced over the introducer.
Segment:5 Summary.
In summary, an experienced laryngoscopist can easily learn the technique of intubation using the GlideScope as it has a similar shape as a Macintosh laryngoscope.
The device is portable and requires minimal setup time, making it particularly useful in the unanticipated difficult airway. The GlideScope is resistant to fogging. Secretions or blood in the oropharynx do not usually significantly interfere with visualization. Like other rigid fiber optic and video laryngoscope, the GlideScope permits visualization of endotracheal tube insertion and advancement.
Although laryngeal exposure is usually significantly improved, the advancement of the endotracheal tube requires a different set of skills as described. Careful preparation of the endotracheal tube with a well lubricated stylet and a 60 degree bend at the distal tip may facilitate the placement of the tube into the trachea.
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