Laryngoscopy - A Definition of Terms

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There can be some confusion with regards to the terminology surrounding laryngoscopy.  The term "video laryngoscopy" can be used imprecisely without specific attention paid to the geometry of the blade containing the video camera.  The geometry of the blade, however, is crucially important as the biomechanics of laryngoscopy differ substantially depending on whether a standard geometry (Macintosh or Miller) blade or a hyperangulated blade is used.  Below you will find specific definition of terms with regards to laryngoscopy and a video demonstrating the differences between direct laryngoscopy, standard geometry video laryngoscopy, and hyperangulated video laryngoscopy.

Direct Laryngoscopy

  • Eyes - direct line of sight to the glottic opening
  • Arms - lifting motion to align the curvature of the airway
  • Tube Passage - linearly into the trachea

Standard Geometry Video Laryngoscopy

  • Eyes - video visualization with the ability to bail to direct line of sight to glottic opening
  • Arms - lifting motion to align the curvature of the airway
  • Tube Passage - linearly into the trachea

Hyperangulated Video Laryngoscopy

  • Eyes - video visualization only (cannot bail to direct laryngoscopy)
  • Arms - rocking motion, blade insertion arounds structures
  • Tube Passage - curved tube introduction around structures, then tube passage into trachea

References

  1. Strayer RJ. Video Laryngoscopy vs. Direct Laryngoscopy. Presentation at American Academy of Emergency Medicine Scientific Assembly in New York, NY; 2014.
  2. Levitan RM. The AirwayCam Guide to Intubation and Practical Emergency Airway Management. Wayne, PA: Airway Cam Technologies, 2004. Print.
  3. Walls RM and Murphy MF. Manual of Emergency Airway Management 4e. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2008. Print.
  4. Levitan RM and Kinkle WC. AirwayCam Pocket Guide to Intubation 2e. Wayne, PA: Airway Cam Technologies, 2007. Print.