An angulated laryngoscope for routine and difficult tracheal intubation

Abstract

A previous study of tracheal intubation in a large series of patients found that multiple attempts at intubation were required in 18% of patients, and that, in 4%, a laryngoscope blade other than that originally selected was required for the successful tracheal intubation. While the curved laryngoscope blade does follow an anatomical arc from teeth to larynx, the upper part of the laryngoscopists view is always partly diminished anteriorly by the curvature of the blade. The view is significantly impaired when optimal placement of the laryngoscope blade is restricted by limited atlanto-occipital extension or by a large tongue or short mandible. Direct laryngoscopy in such circumstances can be facilitated by using an angulated straight-bladed laryngoscope. I have designed and tested such a blade.