Name:
Levitan Laryngoscope
Description:
Levitan Laryngoscope
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/12fc165d-dc84-44e7-a8e3-7f5eafa0303c/thumbnails/12fc165d-dc84-44e7-a8e3-7f5eafa0303c.jpg?sv=2019-02-02&sr=c&sig=9xTJm6jZFzQwC5H8aMzrG1olI5SmaVZumPFD2ygavwI%3D&st=2023-03-24T00%3A30%3A16Z&se=2023-03-24T04%3A35%3A16Z&sp=r
Duration:
T00H03M50S
Embed URL:
https://stream.cadmore.media/player/12fc165d-dc84-44e7-a8e3-7f5eafa0303c
Content URL:
https://asa1cadmoremedia.blob.core.windows.net/asset-2a85add0-40d2-4c22-ae91-9532ad1aaaae/Hung_10_Levitan.mov
Upload Date:
2022-02-27T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
Segment:1 Device.
The Levitan scope is an inexpensive fiberoptic scope in a semi-rigid malleable stylet that can accommodate tracheal tubes greater than 7 millimeter internal diameter. The image is delivered to a proximal eyepiece, which is compatible with standardized camera adapters. The light source is supplied by an adapter from a standard green line handle.
Segment:2 Preparation.
To minimize fogging, the device should be prepared with an anti-fogging solution, warm water immersion, or warming the device using an external source of heat such as the bear hugger. The stylet should be well lubricated before inserting into a tracheal tube. The tracheal tube should be cut to 26 centimeters before loading, such that once it is connected to the 15 millimeter connector fixed on the stylet's handle, the stylet tip will be placed just within the distal tracheal tube.
To remove blood and secretions, the hypopharynx should be suctioned prior to intubation.
Segment:3 Technique.
Although the Levitan scope can be used alone or in conjunction with a laryngoscope, it is our preference to use the Levitan scope together with laryngoscope. If it is used with a laryngoscope, the distal angulation should not be more than 30 degrees. Following denitrogenation, and with the patient placed in a sniffing position, the laryngoscope is inserted into the vallecula to elevate the epiglottis.
If the glottis is visualized, the trachea is intubated under direct vision. In the event that only the epiglottis is seen, the tip of the Levitan scope with the loaded tracheal tube is then placed under the epiglottis, and the practitioner uses the Levitan scope to locate the glottic opening. Once the laryngeal aperture is identified, the tip of the Levitan scope with the tracheal tube is inserted through the chords and the tube is advanced off the stylet into the trachea.
Two placements should be confirmed using end-tidal CO2 and auscultation.
Segment:4 Trouble Shooting.
Fogging can be problematic. Meticulous scope preparation is needed by performing an anti-fogging maneuver, and ensuring the oropharynx has been suctioned prior to tracheal intubation. Despite a good glottic view, advancing the tracheal tube into the trachea can be difficult.
To avoid this, the tube should be immersed in warm saline solution prior to its use to reduce its stiffness and memory of its natural curvature. In addition, reverse loading of the tracheal tube onto the stylet may minimize the tendency of the tube tip to bend anteriorly while advancing the tube into the trachea. With reverse loading, the tip of the tracheal tube is more likely to be directed down the lumen of the trachea, making it easier to advance.
Segment:5 Summary.
The Levitan scope is a fiberoptic scope in a semi-rigid malleable stylet that can be used to direct the tracheal tube through the glottic opening under indirect vision. It is best to use the scope together with the laryngoscope. In order to have a successful intubation, careful preparation of the device and regular practice are necessary.
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