Airway Notes: The Laryngoscope

In this week’s installment of Airway Notes, we take a look at the laryngoscope used for direct laryngoscopy (DL). DL is becoming a less commonly used skill in favor of video laryngoscopy (VL), but I think it is still an essential skill for airway management. There are 2 main types of blades, the Miller and the MacIntosh and each has its benefits and proponents (I’m a Mac guy, myself). You should be familiar with the use of both, but focus on mastering one before moving on the other.

In the IG post, I show examples of a slightly different way to hold the laryngoscope than how most of us were probably taught. This was taught to me by one of my attendings, an anesthesia critical care physician named Habib Srour. Habib is an incredibly smart guy and when he showed me this technique it instantly made so much sense. It takes the pressure off of the hand and wrist and allows the hand and lower arm to serve as one unit. The force of lifting then is transferred to the elbow and ultimately to the shoulder and upper arm, MUCH stronger than the wrist and forearm. This allows for more lifting force without the urge to rock backwards on the handle, risking damage to the teeth and lips. It is probably the single best tip I’ve gotten in regards to DL.

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