Innovative Laryngoscope Could Make Difficult Intubations Easier

A vision-enhancing laryngoscope tool may make it easier to place assisted breathing devices under difficult circumstances.

Researchers at the Medical College of Georgia (MCG; Augusta, GA, USA) developed the Video Rigid Flexible Laryngoscope (RIFL), which is composed of endotracheal tubes surrounding a rigid cylindrical body featuring an illuminated light emitting diode (LED) camera at one end, and a video screen at the other. The light and camera help guide the scope down the airway. The tube is placed and released from the scope. The device is the first of its kind to merge two technologies -- video and articulation, and is being used successfully at the MCG Health Medical Center and at other hospitals in California, North Carolina, Washington, and Wisconsin. The RIFL was presented at the American Society of Anesthesiologists conference, held during October 2009 in New Orleans (LA, USA).

"Any obstructions are easier to see because of the camera and lighted tip. The flexibility of the tip also makes it easier to navigate. There is also less physical pressure on the patient, so the risk of associated trauma is reduced,” said Harsha Setty, M.D., a third-year anesthesiology resident at MCG, who developed the RIFL. "It could be used in emergency rescue situations where patients are airlifted by helicopters and intubation is difficult because their heads are typically placed against a wall; in those cases, rescue workers have to intubate from the front, and the camera on the RIFL makes that easier.”

During normal intubation, the physician stands behind the patient's head and uses a metal laryngoscope to open the mouth and guide a flexible plastic tube into the trachea, which is used to maintain a patient's airway and provide a pathway for mechanical ventilation if necessary. Some diseases, such as head and neck cancer, can make intubation harder; in other cases, anatomical variations, such as shorter necks and bucked teeth, can make tube placement more challenging, and can sometimes be traumatic for patients and lead to problems such as cracked teeth.

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