Name: ACA- Hung 4e- Tracheal Intubation Using the Storz Video Macintosh Laryngoscope

Description: ACA- Hung 4e- Tracheal Intubation Using the Storz Video Macintosh Laryngoscope

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Upload Date: 2023-11-24T00:00:00.0000000

Transcript: Language: EN.
Segment:0 .

Segment:1 Device.
The Storz video Macintosh laryngoscope-- or V-MAC in short-- has a fiber optic bundle that passes through a metal channel along the Macintosh shaped blade, which connects to a video camera. A video cable and power supply passes to a video card housing a light source, video processor, and monitor.
Segment:2 Preparation.
It is our preference to use a malleable stylet with the endotracheal tube. A lubricant should be applied to the stylet before loading into the endotracheal tube. It is also our preference to bend the distal end of the tube and stylet assembly to about 60 degrees to facilitate intubation. To prevent the tip of the tube from hanging up anteriorly while advancing the tube into the trachea during tracheal intubation, it is recommended to complete a reverse loading of the endotracheal tube 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 Bair Hugger.
Segment:3 Technique.
The head and neck of the patient should be placed in a sniffing position. The patient is well oxygenated before performing the tracheal intubation. The V-MAC is held by the left hand, and the blade is slowly advanced to the base of the tongue, which is displaced to the left of the blade.
Once the epiglottis is identified, the tip of the blade is then advanced into the vallecula, and hyoepiglottic ligament is pressed. If the glottis can be seen, tracheal intubation can be performed under direct vision. If only the epiglottis can be seen, the styleted tube is 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 the trachea. After intubation, the V-MAC video laryngoscope is then removed. The 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.
As stated previously, this can be minimized by the reverse loading of the tracheal tube onto the stylet. In addition, the shape and angle of bending of the styleted tube can also be altered. Fogging can be problematic, but meticulous preparation of the device prior to intubation will help to minimize this problem.
Segment:5 Summary.
In summary, the Storz video Macintosh laryngoscope is a modified Macintosh laryngoscope which provides an improved glottic view during tracheal intubation.
Although laryngeal exposure is usually excellent, the advancement of the endotracheal tube requires a different set of skills.

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