9.11
Laryngoscopy
Preoxygenation
- Also referred to as “de‐nitrogenation” (Figure 9.17)
- Technique
- Delivery of 100% oxygen until patient has an ETO2 concentration of >0.7
- Done prior to laryngoscopy to allow for a period of apnea without significant desaturation
- Need to have a good seal around nose and mouth to prevent room air entrainment
- May need another provider for patient with difficult airway to achieve adequate ventilation
- May need an airway adjunct device to be successful
- Consider ETO2 concentration of > 0.8–0.9 in patients who may have difficulty with mask ventilation and/or intubation
- Beards
- Edentulous
- ↑ BMI
- Facial deformities
- History of difficult airway
- OSA
Laryngoscopes
- Blades
- Reusable and single use types
- Older ones have light bulbs on blade
- Newer ones are fiberoptic
- Common blades
- Macintosh (Figure 9.18)
- Curved
- Miller (Figure 9.18)
- Straight
- Wis‐Hipple
- Mostly for peds
- Phillips
- Popular for peds
- Macintosh (Figure 9.18)
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