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Evaluation of the GlideScope ® for tracheal intubation in patients with cervical spine immobilisation by a semi‐rigid collar
Author(s) -
Bathory I.,
Frascarolo P.,
Kern C.,
Schoettker P.
Publication year - 2009
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2009.06075.x
Subject(s) - medicine , laryngoscopy , intubation , stylet , tracheal intubation , cervical collar , collar , anesthesia , cervical spine , surgery , laryngoscopes , mechanical engineering , engineering
Summary Application of cervical collars may reduce cervical spine movements but render tracheal intubation with a standard laryngoscope difficult if not impossible. We hypothesised that despite the presence of a Philadelphia Patriot ® cervical collar and with the patient’s head taped to the trolley, tracheal intubation would be possible in 50 adult patients using the GlideScope ® and its dedicated stylet. Laryngoscopy was attempted using a Macintosh laryngoscope with a size 4 blade, and the modified Cormack–Lehane grade was scored. Subsequently, laryngoscopy with the GlideScope was graded and followed by tracheal intubation. All patients’ tracheas were successfully intubated with the GlideScope. The median (IQR) intubation time was 50 s (43–61 s). The modified Cormack–Lehane grade was 3 or 4 at direct laryngoscopy. It was significantly reduced with the GlideScope (p < 0.0001), reaching grade 2a in most patients. Tracheal intubation in patients wearing a semi‐rigid collar and having their head taped to the trolley is possible with the help of the GlideScope.