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Chapter 14 - Tracheal Intubation: Direct Laryngoscopy

from Section 1 - Airway Management: Background and Techniques

Published online by Cambridge University Press:  03 October 2020

By
Keith Greenland  and
Richard Levitan
Edited by
Tim Cook  and
Michael Seltz Kristensen
Tim Cook
Affiliation:
Royal United Hospital, Bath, UK
Michael Seltz Kristensen
Affiliation:
Rigshospitalet, Copenhagen University Hospital, Denmark
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Summary

Direct laryngoscopy should be preceded by airway assessment and discussing rescue strategies with assisting staff. The initial plan and rescue techniques should be based on an understanding of normal airway anatomy and its variants. This chapter uses the two curve theory and the three column model to describe and functionally classify both the normal and difficult airways. This classification then provides the operator with an understanding of the various causes of difficult airways and how they are related to each other and airway morphology (two curve theory). These two concepts form the basis for the decision process to performing direct laryngoscopy and choosing the right laryngoscope blade for the job. Endobronchial intubation is discussed in detail.

Keywords

Airway managementdifficult airwayendobronchial intubationlaryngoscopy – directstrategythree columnstracheal intubationtwo curves
Type
Chapter
Information
Core Topics in Airway Management , pp. 122 - 129
Publisher: Cambridge University Press
Print publication year: 2020

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References

Further Reading

Greenland, KB (2008). A proposed model for direct laryngoscopy and tracheal intubation. Anaesthesia, 63, 156–161.CrossRefGoogle ScholarPubMed
Greenland, KB (2010). Airway assessment based on a three column model of direct laryngoscopy. Anaesthesia and Intensive Care, 38, 14–19.Google Scholar
Greenland, KB. (2012). Reappraisal of adult airway management. In: Riley, R (Ed.), Australasian Anaesthesia 2011. Melbourne: Australian and New Zealand College of Anaesthetists. pp. 57–65.Google Scholar
Levitan, RM, Heitz, JW, Sweeney, M, Cooper, RM. (2011). The complexities of tracheal intubation with direct laryngoscopy and alternative intubation devices. Annals of Emergency Medicine, 57, 240–247.CrossRefGoogle ScholarPubMed

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