Tips and troubleshooting for use of the glidescope 4. After intubation, the oral airway should be examined during laryngoscope withdrawal. American journal of emergency medicine aime airway. Complications associated with the use of the glidescope. Glidescopeassisted fiberoptic bronchoscope intubation in. The avl design is based on the glidescope gvl, which is clinically proven to achieve a cormack. The purpose of this standardized procedure is to allow the. Standardized procedure endotracheal intubatioin adults. The glidescope titanium reusable and spectrum single. Hospital procedures consultants glidescope intubation hospitalist and emergency procedures course hospitalist procedures em. Protection afforded by respirators when performing.
Glidescopes, one of the several videolaryngoscopes in use, are very easy to use. A total of 56 american society of anaesthesiologists asa physical status i or ii patients scheduled for elective surgery requiring endotracheal intubation under general anaesthesia, without. The glidescope titanium system is equipped with video and audio recording features and the ability to save a snapshot of the live display on the monitor. Glidescope go, a new portable video laryngoscope medgadget. Panel a the endotracheal tube, which was placed under glidescope guidance, has perforated the right anterior tonsillar pillar. A difficult intubation is still one of the most daunting challenges in anesthesiology. Glidescope video laryngoscope systems are ce marked in accordance with the medical device directive, and the verathon inc.
Penetrating injury of the soft palate during glidescope. However, intubation with the glidescope is very different than direct laryngoscopy. Comparison of ease of intubation between glidescope and cmac. Intubation secures a patients airway during surgery, or if breathing has become difficult due to an airway blockage, respiratory illness, or trauma. Posted on july 30, 2015 january 12, 2020 author christine whitten 8 comments. Harborview medical center, university of washington, seattle, washington. I have seen many novice glidescope users struggle to.
Pdf methods to improve success with the glidescope. We hypothesized that the first pass success rate with one particular video laryngoscope, the glidescope, would be higher than the success rate with direct laryngoscopy. The glidescope video laryngoscope is a new intubating device. Improve training and document intubation results with features such as snapshot and video recording. The ease of obtaining a good view of glottis with glidescope videolaryngoscope verathon medical, bothell, wa has led to its increasing popularity over recent years.
Nov 26, 2014 hello i know this might be a silly question, but would anyone like to share any tips to optimize glidescope intubations. Topics covered include glidescope design considerations, general usage tips, use in obese patients, use in pediatric patients, use as an adjunct to fiberoptic intubation, and other matters. The glidescope direct resembles a traditional macintosh direct laryngoscope with the addition of a video camera near the end of the blade, permitting both direct laryngoscopy and a video display of the airway. Glidescope intubation in both primary airway management and rescuefailed. Rigid video laryngoscopes are popular alternatives to direct laryngoscopy for intubation, but further large scale prospective studies comparing these devices to direct laryngoscopy in routine anesthesiology practice are needed.
The ranger system is designed for field military and pre. Movement during endotracheal intubation using a direct laryngoscope has been reported to influence the protective performance of respirators. Get a better airway view with a large, full color monitor. Apr 19, 2018 movement during endotracheal intubation using a direct laryngoscope has been reported to influence the protective performance of respirators. Glidescope intubation in both primary airway management and rescuefailed direct laryngoscopy.
A glidescope gs is a video device that helps specially trained health care providers see a patients airway during endotracheal intubation. Dont insert the blade too deeply one of the most common errors is to insert the gvl as deeply as you possibly can placing the very tip of the glidescope blade on the anterior commissure of the vocal cords like a mac blade. The distal third of the blade angles upward at about 60 degrees. This high quality video demonstrates a glidescope intubation on a live patient. Routine clinical practice effectiveness of the glidescope in difficult airway management an analysis of 2,004 glidescope intubations, complications, and failures from two institutions. Page 17 glidescope direct intubation trainer the glidescope direct intubation trainer is designed to work with the glidescope video monitor. Nasal cannula is left in place throughout the intubation attempt. Routine clinical practice effectiveness of the glidescope in. One of the tools used to assist with a difficult tracheal intubation is the glidescope gs verathon, bothell, wa, usa. The image appears on a small, color, standalone video monitor. Traumatic glidescope video laryngoscopy resulting in. A comparison of two glidescope intubation techniques. Use video laryngoscope system is designed for 1st pass success.
An intubation technique for the glidescope is recommended in the literature. Alternatively, you can download the file locally and open with any standalone pdf reader. The analysis aims to determine the success of gvl intubation in airways predicted to be easy. Designed for 1st pass success in military and emergency settings, the ranger system features rugged. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a pdf plugin installed and enabled in your browser. May 31, 20 a difficult intubation is still one of the most daunting challenges in anesthesiology.
The glidescope video laryngoscope, verathon medical, has a color camera embedded in a curved, high impact laryngoscope blade that resembles a macintosh mac blade with a greater curvature. Here, we report that, under the assistance of both the glidescope and a fiberoptic bronchoscope, tracheal intubation was accomplished successfully in a 50yearold woman with severe rheumatoid arthritis who underwent tongue lump resection under general anesthesia. Johndoyle,md,phdc,d,e a emergency services institute, cleveland clinic health systems, cleveland, oh b case western reserve university metrohealth medical center, cleveland, oh. An observational study using propensity score matching. The gs is a video laryngoscope that has a 60 degree angle blade with a builtin highresolution camera and a light source assembled. Pdf occasionally intubation of patients is difficult using a video laryngoscope glidescope, verathon medical because of an inability to guide.
Glidescope video laryngoscope systems are ce marked in accordance with the medi cal device directive, and the verathon inc. Use of the glidescoperanger for prehospital intubations by anaesthesia trained emergency physicians an observational study the harvard community has made this article openly available. Cases have been reported of trauma to the oropharyngeal structures during video laryngoscopeassisted endotracheal intubations with etts loaded with rigid stylets. Time to intubation was recorded by blinded assessors. Verathon, a company thats part of roper technologies, has released a new portable video laryngoscope, the glidescope go. Nov 05, 2014 the glidescope device has been in use in this facility since 2006. One of the most commonly performed emergency and hospital based procedures, endotracheal intubation is now commonly performed using video laryngoscopy. Multimodal airway visualization learn more singleuse bronchoscope learn more spectrum singleuse video laryngoscope glidescope. So much so that it is not only frequently used as the firstattempt intubation device. Keim, md, ms department of emergency medicine, the university of arizona college of medicine, tucson, arizona. This protocol covers the task of endotracheal intubation placement by an advanced health practitioner. Comparison of conventional glidescope to singleuse glidescope cobalt for orotracheal intubation. Glidescope ranger is a portable, compact video laryngoscope that provides a clear, real. Posted on june 26, 2018 september 22, 2019 author christine whitten 4 comments.
Because the square glidescope videolaryngoscope blade with a significant distal angulation may make use of the magill forceps very awkward or impossible, the most important aspect of successful nasotracheal intubation with a glidescope videolaryngoscope is to guide the tube tip toward a visualized glottis by auxiliary maneuvers, such as left or. This study was performed to investigate the use of the glidescope for tracheal intubation in 15 patients wearing halo vests scheduled for elective surgery under general anesthesia. See how we work together glidescope bflex video baton 2. A comparison of glidescope video laryngoscopy to direct laryngoscopy in 822 intubations john c. Glidescope technique for intubation in small mouths. The glidescope should be midline when you lift the jaw for intubation. Glidescope technique for intubation in small mouths the. Palatopharyngeal wall perforation during glidescoper intubation. Palatopharyngeal wall perforation during glidescoper. Routine clinical practice effectiveness of the glidescope. The glidescope direct resembles a traditional macintosh direct laryngoscope with the addition of a video.
Preoperative airway assessments were evaluated to predict the difficulty of tracheal intubation. Twenty as patients were chosen to undergo tracheal intubation by the glidescope. The recipients will receive an email message that includes a link to the selected article. However, we would like to offer several suggestions for safe and successful intubation. However, while advancing the endotracheal tube from mouth to pharynx, the tip of the endotracheal tube that could potentially cause damage to soft tissue cannot be monitored on the screen of the glidescope. These procedures are intended to describe procedures performed by nurse practitioners andor certified nurse midwives depending on the clinical privileges granted to the individual practitioner at uc san diego health. Comparison of ease of intubation between glidescope and c. The glidescope device has been in use in this facility since 2006. Methods we performed an observational study using registry data of five emergency departments. There have been no previously published reports of injuries related to glidescope laryngoscopy, but perforation of the palatopharyngeal arch occurring in two patients demonstrates a rare but potentially important complication of the gvl. The aim of the study was to investigate the use of the glidescope for tracheal intubation in patients with ankylosing spondylitis as undergoing general anaesthesia. Practitioners performing the intubation included medical students, student nurse anesthetists, anesthesiology residents at all levels of training, certified registered nurse anesthetists, and attending anesthesiologists. Glidescope video laryngoscopes are designed to deliver high resolution airway views when used with compatible glidescope video monitors. Ibinson, jw and ezaru, cs and cormican, ds and mangione, mp 2014 glidescope use improves intubation success rates.
Penetrating injury of the soft palate during glidescope int. A comparison of two glidescope intubation techniques full. Safe and successful intubation using the glidescope. Standardized procedure endotracheal intubatioin adults 1. Health, general colposcopes health aspects usage endoscopes gastroscopes uterine cancer care. Glidescope intubation video, endotracheal intubation. Reported complications associated with the use of glidescope. Use of the endoflex endotracheal tube as a styletfree alternative in glidescope intubations, canadian journal of anesthesiajournal canadien danesthesie, 2008, pp. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Pdf glidescope use improves intubation success rates. Videoassisted techniques offer the advantage of abandoning the need for alignment of the optical axis in the pharynx and mouth to visualize the entrance of the larynx. The laryngoscope is the structure at the top of the image, the uvula is at the bottom, and the tongue is on the left side. The patient is positioned with head of bed elevated to 20 degrees, the glidescope is readied and 200 mg of succinylcholine and 150 mg of ketamine are pushed. Verathon, bothell, wa, usa has a hyperangulated blade, the tip of which is equipped with a camera.
The success rates in adult patients were evaluated and compared with those of conventional laryngoscope cl. Of legos and laryngoscopes 56yearold male brought in by ambulance with a report of left arm shaking, left. Intubations using glidescope video laryngoscopes require approximately 0. The use of the glidescope for tracheal intubation in. A technique is described for a glidescope technique to use to intubate the patient with a small, narrow mouth or high arched palate. Panel b the endotracheal tube has been removed, allowing for visualization of the perforation of the anterior tonsillar pillar. Listing a study does not mean it has been evaluated by the u.
Objective to investigate the use and success rates of the glidescope gvl by emergency physicians eps during the initial two years after its introduction. Comparison of conventional glidescope to singleuse. Glidescope video laryngoscopes combine innovative designs in reusable and single use options to enable intubations across a wide range of patient types, weights, and clinical settings. At all times, the advancement of the blade should be midline, gentle and under vision if possible. Recipients may need to check their spam filters or confirm that the address is.
Use of the endoflex endotracheal tube as a styletfree. Eight intubations using the color glidescope video. Routine clinical practice effectiveness of the glidescope in difficult. Reverse loading to facilitate glidescope intubation pdf. Glidescopeassisted fiberoptic bronchoscope intubation in a. The glidescope screen shows clear visualization of the cords, but something is wrong. The glidescope titanium system saves this data to a usb flash drive, and you can view the recordings or snapshots on the video monitor or a computer. Laryngoscopy via macintosh blade versus glidescope.
Details of reported complications associated with the use of glidescope are summarised in table 3. The gliderite rigid stylet is designed to complement the angle of the glidescope video laryngoscope to facilitate intubation. Close available for download in the bioclinical services library if you already belong to a hospital with access, please login via your intranet. Glidescope core is the first and only airway visualization system to offer live pictureinpicture imaging, giving you the power to view the airway via a glidescope video laryngoscope and bflex, a singleuse flexible bronchoscope. Nov 22, 2012 this case shows a complication of endotracheal intubation using a video laryngoscope.
Jun 05, 2012 hospital procedures consultants glidescope intubation hospitalist and emergency procedures course hospitalist procedures em. If your institution subscribes to this resource, and you dont have a myaccess profile, please contact your librarys reference desk for information on how to gain access to this resource from offcampus. Tricks for successful intubation posted on july 30, 2015 january 12, 2020 author christine whitten 8 comments glidescopes, one of the several videolaryngoscopes in use, are very easy to use. It provides a consistently clear view of a patients airway, enabling quick intubations. It can be taken to sporting events, disaster zones, or used inside the.