Glidescope Intubation

Glidescope Intubation

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This high quality video demonstrates a glidescope intubation on a live patient. One of the most commonly performed emergency and hospital based procedures, endotracheal intubation is now commonly performed using video laryngoscopy.  Glidescope intubation is shown step by step. This is useful in difficult airway management.  Clinical pearls and common pitfalls associated with indirect laryngoscopy are discussed in detail.  The video is not downloadable but may be accessed indefinitely by internet from any computer, smart phone, or tablet. Click below to preview the Glidescope video.

 

This is a picture of a glidescope blade. It is similar to a standard Mac 3 blade, but there are very distinct differences from the standard laryngoscope blade. 

First of all, there is anti-fogging technology that helps visualization when there is trauma, bleeding, excessive secretions compared with direct laryngoscopy.

The second distinct feature is that compared with a standard Macintosh 3 blade, the glidescope blade has a 60 degree angulation compared to a 20 degree angulation in the standard Macintosh blade. This improves the ability to access a very anterior larynx.

The third feature is that there is camera near the tip of the blade, which improves visualization of the larynx and allows for real time video laryngoscopy. 

We're now pre-oxygenating the patient with 100% oxygen. Now we're placing the glidescope stylet into the endotracheal tube. This is a special stylet that is rigid and has a more angulated curve. 

Now, we're applying the glidescope blade in the midline of the mouth, following the curve of the tongue. As we introduce the blade we're following the tongue down to the base, and we are now starting to see the larynx, there is the epiglottis that is starting to come up, and we can see to the vocal cords in the middle. And now the blade is relaxed, and now is elevated again to again visualize the vocal cords.

The endotracheal tube is now being introduced along the right side of the mouth and as it is advanced, you can see the tip of the endotracheal tube that is approaching the vocal cords. Once it's at the tip of the vocal cords, your thumb can help pull back the stylet out as the endotracheal tube is advanced in one centimeter increments until the endotracheal tube passes through the vocal cords and you can see the thumb is being used to pull back the stylet as the endotracheal tube is advanced further. 

Then the stylet is fully removed leaving the endotracheal tube in place. The glidescope is removed and now the cuff of the endotracheal tube will be inflated with approximately five to seven milliliters of air until the cuff is fully inflated. The endotracheal tube is now connected to the ventilator and the procedure is complete.