McGrath® Video Laryngoscope
McGrath® Video Laryngoscope
The McGrath Video Laryngoscope is a compact and portable video laryngoscope. It is powered by a single 1.5 volt AA battery housed in its handle. It has an adjustable stainless steel camera stick that can be advanced or retracted to three different lengths. The camera stick contains two high-intensity LEDs, and a video camera.
A single use polycarbonate blade cover with a maximum height of 13 millimeters covers the camera stick and clicks securely into place. A 1.7 inch LCD screen is mounted atop the handle and can be tilted and swiveled for an optimal viewing angle.
A malleable stylet loaded into the tracheal 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 tracheal tube and stylet assembly to 60 to 75 degrees to facilitate intubation. To prevent the tip of the tube hanging up anteriorly while advancing the tube into the trachea during tracheal intubation, it is recommended to complete a reverse loading of the tracheal onto the stylet.
To minimize fogging, it is recommended to prepare the device with an anti-fogging solution or warming the device using an external source of heat such as the bear hugger. Special positioning of the head and neck of the patient is generally not required.
Tracheal intubation should be performed following an appropriate dinitrogenation of the patient.
The McGrath Video Laryngoscope is introduced into the mouth in the midline, and maintained in the midline as it is rotated around the tongue. The blade is preferentially introduced into the vallecula, and the glottis can be visualized easily with a gentle lifts. The styletted endotracheal tube is then inserted through the right corner of the mouth under direct vision, and the tip of the tube is directed towards the larynx through the video display.
Once the tube has entered the glottic opening, it is advanced over the stylet into trachea. After intubation, the McGrath Video Laryngoscope is then removed. The tracheal tube placement should be confirmed using entitle CO2 and auscultation. Occasionally, despite excellent laryngeal exposure, the tip of the endotracheal tube cannot be advanced through the glottis.
After confirming that the angle of the McGrath Video Laryngoscope 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, an Eschmann Tracheal Introducer can be introduced into the trachea, following which the endotracheal tube is visually advanced over the introducer.
Segment:4 Trouble Shooting.
Occasionally, the image on the screen flickers, or has lines across it. This may indicate that the battery should be changed, or the contact strips on the camera stick should be cleaned.
In summary, the McGrath Video Laryngoscope is portable, and requires minimal setup time. Although laryngeal exposure is significantly improved, the advancement of the endotracheal tube requires a different set of skills.
Careful preparation of the endotracheal tube with a reverse loading of the tube onto a well lubricated stylet, and a 60 degree bend at the distal tip, may facilitate the placement of the tube into the trachea.