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. Jun 05, 2012 hospital procedures consultants glidescope intubation hospitalist and emergency procedures course hospitalist procedures em. The glidescope device has been in use in this facility since 2006. A technique is described for a glidescope technique to use to intubate the patient with a small, narrow mouth or high arched palate. 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.
The glidescope screen shows clear visualization of the cords, but something is wrong. Safe and successful intubation using the glidescope. Multimodal airway visualization learn more singleuse bronchoscope learn more spectrum singleuse video laryngoscope glidescope. Laryngoscopy via macintosh blade versus glidescope. An observational study using propensity score matching. Comparison of ease of intubation between glidescope and c. Use of the glidescoperanger for prehospital intubations by. The purpose of this standardized procedure is to allow the.
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. Routine clinical practice effectiveness of the glidescope. Glidescope video laryngoscope systems are ce marked in accordance with the medi cal device directive, and the verathon inc. 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. The gs is a video laryngoscope that has a 60 degree angle blade with a builtin highresolution camera and a light source assembled. Glidescope video laryngoscope systems are ce marked in accordance with the medical device directive, and the verathon inc. The image appears on a small, color, standalone video monitor.
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. Protection afforded by respirators when performing. An intubation technique for the glidescope is recommended in the literature. Recipients may need to check their spam filters or confirm that the address is. 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. Listing a study does not mean it has been evaluated by the u. Routine clinical practice effectiveness of the glidescope in. One of the most commonly performed emergency and hospital based procedures, endotracheal intubation is now commonly performed using video laryngoscopy. Ibinson, jw and ezaru, cs and cormican, ds and mangione, mp 2014 glidescope use improves intubation success rates. However, we would like to offer several suggestions for safe and successful intubation. 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 titanium reusable and spectrum single. Reverse loading to facilitate glidescope intubation pdf. Practitioners performing the intubation included medical students, student nurse anesthetists, anesthesiology residents at all levels of training, certified registered nurse anesthetists, and attending anesthesiologists. The gliderite rigid stylet is designed to complement the angle of the glidescope video laryngoscope to facilitate intubation. Glidescope technique for intubation in small mouths. Intubations using glidescope video laryngoscopes require approximately 0. Verathon, a company thats part of roper technologies, has released a new portable video laryngoscope, the glidescope go. Reported complications associated with the use of glidescope. Verathon, bothell, wa, usa has a hyperangulated blade, the tip of which is equipped with a camera.
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. Hospital procedures consultants glidescope intubation hospitalist and emergency procedures course hospitalist procedures em. The ranger system is designed for field military and pre. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Health, general colposcopes health aspects usage endoscopes gastroscopes uterine cancer care. Cases have been reported of trauma to the oropharyngeal structures during video laryngoscopeassisted endotracheal intubations with etts loaded with rigid stylets. Routine clinical practice effectiveness of the glidescope in difficult airway management an analysis of 2,004 glidescope intubations, complications, and failures from two institutions. Nasal cannula is left in place throughout the intubation attempt. Posted on june 26, 2018 september 22, 2019 author christine whitten 4 comments.
A glidescope gs is a video device that helps specially trained health care providers see a patients airway during endotracheal intubation. Use of the endoflex endotracheal tube as a styletfree alternative in glidescope intubations, canadian journal of anesthesiajournal canadien danesthesie, 2008, pp. Pdf methods to improve success with the glidescope. Glidescopeassisted fiberoptic bronchoscope intubation in a. Therapeutic tips and troubleshooting for use of the glidescope video laryngoscope for emergency endotracheal intubation. The distal third of the blade angles upward at about 60 degrees. Standardized procedure endotracheal intubatioin adults.
Nov 26, 2014 hello i know this might be a silly question, but would anyone like to share any tips to optimize glidescope intubations. 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. It can be taken to sporting events, disaster zones, or used inside the. Methods we performed an observational study using registry data of five emergency departments. Glidescope video laryngoscopes are designed to deliver high resolution airway views when used with compatible glidescope video monitors. Get a better airway view with a large, full color monitor. Posted on july 30, 2015 january 12, 2020 author christine whitten 8 comments. Use of the endoflex endotracheal tube as a styletfree.
Penetrating injury of the soft palate during glidescope. Glidescopeassisted fiberoptic bronchoscope intubation in. Tips and troubleshooting for use of the glidescope 4. The success rates in adult patients were evaluated and compared with those of conventional laryngoscope cl. Panel b the endotracheal tube has been removed, allowing for visualization of the perforation of the anterior tonsillar pillar. The glidescope video laryngoscope is a new intubating device. 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. Objective to investigate the use and success rates of the glidescope gvl by emergency physicians eps during the initial two years after its introduction. A comparison of two glidescope intubation techniques full. A difficult intubation is still one of the most daunting challenges in anesthesiology.
Glidescopes, one of the several videolaryngoscopes in use, are very easy to use. Panel a the endotracheal tube, which was placed under glidescope guidance, has perforated the right anterior tonsillar pillar. 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. Eight intubations using the color glidescope video. Routine clinical practice effectiveness of the glidescope in difficult. 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. It provides a consistently clear view of a patients airway, enabling quick intubations. Glidescope technique for intubation in small mouths the. Twenty as patients were chosen to undergo tracheal intubation by the glidescope. The avl design is based on the glidescope gvl, which is clinically proven to achieve a cormack. After intubation, the oral airway should be examined during laryngoscope withdrawal. At all times, the advancement of the blade should be midline, gentle and under vision if possible.
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. 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. A comparison of two glidescope intubation techniques. Palatopharyngeal wall perforation during glidescoper. Nov 05, 2014 the glidescope device has been in use in this facility since 2006. American journal of emergency medicine aime airway. Glidescope ranger is a portable, compact video laryngoscope that provides a clear, real. I have seen many novice glidescope users struggle to. 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. Apr 19, 2018 movement during endotracheal intubation using a direct laryngoscope has been reported to influence the protective performance of respirators.
Comparison of conventional glidescope to singleuse glidescope cobalt for orotracheal intubation. 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. This protocol covers the task of endotracheal intubation placement by an advanced health practitioner. Nov 22, 2012 this case shows a complication of endotracheal intubation using a video laryngoscope. Pdf occasionally intubation of patients is difficult using a video laryngoscope glidescope, verathon medical because of an inability to guide. Comparison of ease of intubation between glidescope and cmac. Use video laryngoscope system is designed for 1st pass success. Close available for download in the bioclinical services library if you already belong to a hospital with access, please login via your intranet. 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. Glidescope intubation in both primary airway management and rescuefailed. Complications associated with the use of the glidescope. Preoperative airway assessments were evaluated to predict the difficulty of tracheal intubation.
Pdf glidescope use improves intubation success rates. Glidescope intubation video, endotracheal intubation. 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. Comparison of conventional glidescope to singleuse. May 31, 20 a difficult intubation is still one of the most daunting challenges in anesthesiology. The analysis aims to determine the success of gvl intubation in airways predicted to be easy. The glidescope should be midline when you lift the jaw for intubation. Details of reported complications associated with the use of glidescope are summarised in table 3. Alternatively, you can download the file locally and open with any standalone pdf reader. 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.
Traumatic glidescope video laryngoscopy resulting in. 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. Keim, md, ms department of emergency medicine, the university of arizona college of medicine, tucson, arizona. So much so that it is not only frequently used as the firstattempt intubation device.
Palatopharyngeal wall perforation during glidescoper intubation. Page 17 glidescope direct intubation trainer the glidescope direct intubation trainer is designed to work with the glidescope video monitor. Glidescope intubation in both primary airway management and rescuefailed direct laryngoscopy. Penetrating injury of the soft palate during glidescope int.
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. Harborview medical center, university of washington, seattle, washington. The use of the glidescope for tracheal intubation in. One of the tools used to assist with a difficult tracheal intubation is the glidescope gs verathon, bothell, wa, usa.
Standardized procedure endotracheal intubatioin adults 1. Designed for 1st pass success in military and emergency settings, the ranger system features rugged. A comparison of glidescope video laryngoscopy to direct laryngoscopy in 822 intubations john c. The glidescope direct resembles a traditional macintosh direct laryngoscope with the addition of a video. 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 recipients will receive an email message that includes a link to the selected article. Movement during endotracheal intubation using a direct laryngoscope has been reported to influence the protective performance of respirators. 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. 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.
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