Intubation Video Laryngoscope: The Ultimate FAQ Guide

I know choosing a suitable intubation video laryngoscope can be an overwhelming task.

A reason this guide will answer all your questions on intubation video laryngoscope.

So, keep reading to learn more.

1.  What Is Intubation Video Laryngoscope?

An Intubation Video Laryngoscope is a device that is used to view the larynx and entire airway which is inserted trans orally.

It has interchangeable blades and a handle with an incorporated short image camera.

The airway anatomy can also be viewed from a stand-alone monitor that is connected to the device.

The manipulation of the Intubation Video Laryngoscope and observation are performed on a single axis.

intubaton video laryngscope

2.  What Are The Advantages Of Intubation Video Laryngoscope?

The advantages of Intubation Video Laryngoscopy include:

1. People can see what is happening

Other team members can visualize the airway anatomy thus prepare them for performing laryngoscopy on their own.

Teaching using visualization achieves a certain degree of success and skills are well transferred.

2. It requires less skill

Reliance on other members of staff for assistance is minimized.

Failure of the airway can be effectively managed immediately by staff with basic knowledge instead of waiting for experienced staff.

3. An official record is provided

Data on the Laryngoscopy process can be recorded for use in reviews later.

Glottic damages can be seen easily viewed without performing further operations thus reducing the trauma on the patient.

4. Portability

The Intubation Video Laryngoscope is not bulky and can be easily carried around for convenience.

This is not possible with flexible fiber optic laryngoscopes.

5. Suboptimal Positioning is Possible

The airway axes don’t necessarily have to be aligned for a good view to be achieved.

This makes it possible to carry out intubation in situations where the neck and head have limited mobility.

3.  What Are The Different Types Of Intubation Video Laryngoscopes?

Intubation Video Laryngoscopes have the following broad categories:

Standard Blade Style

These devices largely resemble the standard Miller or MacIntosh design of Laryngoscope but with a camera.

The camera provides an upper airway image on a video display.

Anatomically Shaped

This device has tube guide channel that directs the endotracheal tube to the glottis.

The major advantage of this device is that the advancement of the endotracheal tube is controlled thereby reducing the intubation time.

Angulated Blade

The main feature of this device is that the blade has marked anterior curve feature based on the sagittal plane.

This allows for the intubation and the visualization of the laryngeal without aligning the laryngeal axes.

4.  What Are The Components Of An Intubation Video Laryngoscopy?

An Intubation Video Laryngoscopy is made up of four major components namely:

I.  A small camera that has very high resolution positioned at the device’s distal tip.

The camera also has a source of light used for illumination while penetrating the airway.

II. A color display monitor that is either cart-based (standalone) or integrated (attached) with controls for adjustment.

To improve the view of the airway, the integrated monitors can be flipped, rotated or angled.

They come with a memory card for saving recordings and downloaded images.

They can also be connected to an external monitor via a video output port incorporated in the monitor.

III. A variety of blades of different shapes and sizes that are either single use or interchangeable reusable.

To prevent the camera lens from being affected by moisture, the blades have a warning feature or anti-fog coating.

IV. For powering the display monitor, light source and the camera, batteries that are non-rechargeable or rechargeable are included.

The internal power sources (

5.  What Are The Complications Associated With The Use Of Intubation Video Laryngoscopy?

Using the Intubation Video Laryngoscopy come with a variety of complications to the patient. They include:

• Hypoxia may be experienced when attempting intubation
• Trauma of the oropharyngeal soft tissue or dental trauma can occur during insertion of the tube.
• The tube can be incorrectly placed, a condition called esophageal intubation
• Aspiration and vomiting may be experienced during insertion of the tube

6.  What Are The Common Errors While Operating An Intubation Video Laryngoscopy?

The normal operations of the Intubation Video Laryngoscope are susceptible to errors that include:

I. The endotracheal tube should be securely held when the stylet is being removed while an assistant pulls it out.

The stylet handle is caudally rotated towards the chest and not pulled straight upwards.

This helps in the easy stylet removal while reducing the risk of the endotracheal tube dislodging.

II. It is important that the appropriate rigid stylet is used for each precise video laryngoscope curvature.

This ensures that the blades curvature is followed during intubation.

III. Both pediatric and adult cuffs must be inflated to the required extent to avert movement. Overinflating the cuffs may result in necrosis.

IV. Difficulty in passing the tube through the airway can be experienced when the video laryngoscope has been inserted too deep.

This is common with acutely curved intubation video laryngoscopes.

7.  How Does A Channeled Compare To A Non-Channeled Intubation Video Laryngoscopy?

The methodological differences of Video Laryngoscopes are majorly determined by the basic type of blade that is either channeled or non-channeled.

The two require different forms handling techniques which its failure or success.

Non-channeled blades were designed for earlier versions of Video Laryngoscopes.

channeled intubation video laryngoscope

The left hand is used to hold the device while using these blades and the right hand independently steers the tracheal tube.

A malleable stylet is required to give the tracheal tube the required shape and enhance its stability.

The stylet is bended depending on the shape of the curvature of the blade.

Conversely, Channeled blades have been designed to expedite the approach of the tip of the tracheal tube towards the glottis.

The have a longitudinal channel where the tracheal tube is inserted for its tip to be visible on the screen permanently.

non channeled intubation video laryngoscope

The tracheal tube follows the Video Laryngoscope blade strictly.

The major disadvantage is that the design is bulkier hence the mouth has to be opened very wide during intubation.

8.  What Are The Factors To Consider When Choosing An Intubation Video Laryngoscope?

There are various factors to consider when sourcing for a useful and lifesaving Intubation Video Laryngoscope.

They include:

Reliability

Because of the life-threatening nature of their operations, they should be extremely reliable to ensure the patient’s safety.

They should not show fuzzy images, have batteries expire without warnings or have poor display lighting.

Screen Size

A larger screen will ensure that the airway is seen more clearly.

Some models have screens integrated on their handles while others directly connect to stand-alone monitors.

The choice of this will depend on the location of use of the Intubation Video Laryngoscope. Portability in the operation room differs from the ICU and the Emergency Room operations.

Ease of Use

The health providers need to have an easy time while operating the Intubation Video Laryngoscopy during an emergency.

This technology should easy to learn and comfortable to use under duress.

Blade Type

The available blade type options are disposable or reusable with the difference arising in cost and usability.

The need for cleaning is eliminated in disposable blades while reprocessing is a challenge in reusable blades.

Clarity

The images of the video laryngoscope have to clear enough for high-quality airway anatomy views.

The device should have anti-fog technology integrated in the camera lens to prevent fig up during procedures.

Power

The choice of power is basically between a rechargeable or a disposable battery.

Whatever option is settled on, the video laryngoscope should have a way of displaying the amount of power remaining.

Design

The two types of Intubation Video Laryngoscope commonly in use are the standard devices and channeled devices.

Standard devices have a blade attached to the device’s handle and the endotracheal tube inserted with a stylus.

Channeled devices have the endotracheal tube loaded into a channel incorporated in the blade. Its responsible for guiding the tip of the blade to its position in the airway.

9.  What Are The Demerits Of Intubation Video Laryngoscopy?

1. Some of the demerits experienced while using the Intubation Video Laryngoscope include:
2. The view of the may be obscured by secretions and fogging of the camera
3. Different models and makes of intubation video laryngoscopes have different operation techniques.
4. They have a longer processing time during medical procedures
5. The perception of depth is lost in an operation due to two-dimensional view which can lead to upper airway injuries
6. Maintenance and the cost of stock acquisition pose an economic issue

10.  How Does Intubation Video Laryngoscope Compare To Video-Assisted Endotracheal Tube (VETT)?

Intubation Video Laryngoscopes provide an indirect glottis visualization with superior quality images in difficult and normal airways.

However, the endotracheal tube may prove difficult to pass into the trachea through the vocal cords.

This will require the use of a stylet but with a video-assisted endotracheal tube (VETT), the stylet is not necessary.

The Video-Assisted Endotracheal Tube is placed between the vocal cords via the trachea.

It provides the lungs with oxygen and inhaled gases while protecting it from contaminations. Contaminants include blood and gastric content.

video assisted endotracheal tube

11.  How Does Direct Laryngoscopy Compare To Intubation Video Laryngoscopy?

Direct Line Laryngoscopy calls for alignment of airway axes using a direct line of sight for ideal glottic visualization.

These axes are aligned using manipulations such as laryngeal manipulation, neck flexion and head extension.

In contrast, Intubation Video Laryngoscopy uses an indirect method through its camera.

This eliminates the necessity of visualizing the airway structures using a direct line of sight thus improving glottic visualization.

direct laryngoscope

12.  What Are The Challenges Faced While Using Intubation Video Laryngoscopy?

Challenges faced while using an Intubation Video Laryngoscope can be categorized in various application field namely:

Emergency and Prehospital Setting

Patients who are in off-site settings or in non-operating rooms have a very high risk of difficult Intubation Video Laryngoscopy.

There is a very high risk of complications due to poor glottic visualization even with an experienced operator.

Intensive Care Unit

ICU patients have a very challenging airway management mostly associated with complications that are life-threatening.

The operators must have exceptional skills due to the urgency of securing airways of unconscious patients.

Cervical Spine Concerns

Utmost precaution and care should be taken when performing Intubation Video Laryngoscopy on cervical spine fracture patients.

Semi-rigid cervical collars that prevent the neck from moving causes poor laryngeal view in intubation.

Obese Patients

The challenge here is posed because the habitus of the obese body makes it technically difficult for tracheal intubation.

This will lead to total failure of the procedure or subsequent soft tissue injuries.

13.  What Are The Modern Design Improvements Of The Intubation Video Laryngoscopy?

Recent advancements in the management of airways has made it possible to make design improvements on the Intubation Video Laryngoscope.

The initial technological advancements included:

• Using a light-emitting diode (LED) as an application
• Video chips made from complementary metal-oxide semiconductors (CMOS) making resulting in a portable video augmentation
• The use of LCD (Liquid Crystal Display Screens)

Modern advancements include using video chips on stylets which incorporate a handle video screen that is easy to view.

Initial stylets used fiber optic bundles that one would place their eye on an eye piece.

Some newer optical stylets have assimilated technology that provides for flexible tips.

Modern technology bronchoscope has a video chip located on its distal end.

Anti-fog capabilities have now been incorporated in the devices and this reduces the instances of poor visibility on the screen.

Some devices have heating elements to counter such scenarios.

14.  How Does The Data Capture Feature Aid In The Intubation Video Laryngoscopy Operation?

This is a very essential capability of the Intubation Video Laryngoscope.

Very challenging and complex intubations can be captured, recorded and saved on the internal memory or an external thumb drive.

The recording can be shared with the patient to show them how the procedure went or it can be stored in their digital medical record.

This can be used they next time they intubate the patient to know the challenges that were faced and manage it effectively.

The records can also be used for teaching purposes for students and operators learning the procedure. They can also be used for scientific research and any other project that seeks to streamline the intubation process.

15.  How Do Straight Blades Compare To Curved Blades In Intubation Video Laryngoscopy?

Intubation Video Laryngoscopy relies on having the three airway axes aligned for the larynx to be visible. Straight and curved blades apply diverse techniques to enable optimal views of the larynx.

Curved blades displace the tongues soft tissue at its base forward so that it can lift the epiglottis and have the larynx come into view.

straight blade

Contrary to this, the straight blade relies on lifting the epiglottis directly while making the tongue flat.

Curved blades are suitable for beginners of the intubation process because of its ease of control due to its broad base and large flange.

Straight blades give a better view but require precise placement for tongue control because it is narrow and flangeless.

curved blades

16.  Who Are The Intended Target Users Of intubation Video Laryngoscopy?

Intubation Video Laryngoscope is mostly used on people who have a projected airway difficulty as an emergency or for secondary care.

The people who operate it include anesthetists, emergency medical services providers and paramedics.

The device is also used by students and progressing medical staff as a tool of training for the Intubation Video Laryngoscopy procedures.

They require training and experience to handle various device designs and control to ensure successful operations.

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