BESDATA Video Laryngoscope - Best Solutions for Difficult Airway

BESDATA Video Laryngoscope: Advanced Airway Management Solutions

The BESDATA video laryngoscope is a state-of-the-art medical device that has achieved CE, FDA, and China FDA certifications. It is also registered with the Ministry of Health (MOH) in over ten countries, including Brazil, Mexico, Thailand, and Germany. Each unit is manufactured in strict compliance with ISO 13485 medical device standards, ensuring consistent quality and reliability for demanding clinical environments.

During challenging periods such as the COVID-19 pandemic, where frontline clinicians faced significant risks of infection from patient secretions during airway intubation, the need for advanced protective measures became paramount. BESDATA video laryngoscopes, with their separate screen design, facilitate increased distance between the clinician and the patient. Furthermore, our single-use video laryngoscopes and disposable stylets are ideal for Emergency Medical Services (EMS) and Intensive Care Unit (ICU) applications. These disposable options eliminate the need for disinfection, thereby preventing cross-contamination and further safeguarding clinicians.

BESDATA video laryngoscopes are engineered with an anti-fog blade and camera, ensuring clear, uninterrupted visualization at any time, without the need for preheating. This feature is critical for rapid response and procedural efficiency. The system also supports video recording and picture capture, enabling comprehensive documentation of trauma cases, procedural review, and valuable training resources for medical professionals.

Beyond individual video laryngoscopes, BESDATA offers a comprehensive airway management ecosystem. This includes a suite of innovative video intubation tools such as video stylets, video laryngeal masks, and video endobronchial tubes. This integrated approach allows clinicians to select the most suitable intubation tools based on their expertise and the specific clinical status of each patient.

The BESDATA video laryngoscope is a dependable intubation tool for both prehospital emergency settings and in-hospital procedures. We believe this presents an excellent opportunity for distributors and agents in the medical device field to market this leading-edge technology. If you are interested, please contact us.

We encourage you to reach out via email or send us an inquiry to learn more.

Video Laryngoscope: The Definitive FAQ Guide

If you have any questions regarding video laryngoscopes, this comprehensive guide provides detailed answers. Explore the sections below to learn everything you need to know about this essential medical technology.

What Is A Video Laryngoscope?

A video laryngoscope is an advanced medical instrument designed to provide an indirect view of the vocal cords and adjacent laryngeal structures. These devices are crucial retraction tools that integrate optical elements and illumination sources. A miniature video camera, typically located at the distal end of the laryngoscope blade, captures real-time images from within the airway, which are then displayed on an attached or separate monitor. This technology allows clinicians to visualize the trachea and guide endotracheal tube placement without needing a direct line of sight.

Video Laryngoscope

What Are The Main Methods For Using A Video Laryngoscope?

While many video laryngoscopes share a physical resemblance with conventional direct laryngoscopes, their primary advantage lies in the integrated video technology, which necessitates adjustments in technique. Traditional direct laryngoscopy relies on achieving a direct line of sight, requiring specific hand-eye coordination. Video laryngoscopy leverages high-quality video imaging, allowing for a modified approach. It is crucial to understand whether a particular video laryngoscope model is best utilized with direct vision, video-assisted vision, or a combination.

The four main phases when using a video laryngoscope typically include:

• Introduction of the laryngoscope
• Obtaining an optimal view of the glottis
• Introduction of the endotracheal tube (ETT)
• Confirmation of intubation

This methodology allows clinicians to capitalize on the benefits of both video imaging and direct visualization for specific aspects of the procedure. A more detailed explanation follows:

Step One: Introduction Of The Laryngoscope

After ensuring proper patient positioning, the video laryngoscope is introduced into the oral pharynx. The device is advanced gently until the blade tip passes the posterior aspect of the tongue. This initial step is typically performed using direct vision, with the operator looking directly into the patient’s mouth, similar to the technique used in direct laryngoscopy.

Step Two: Obtain A Suitable View

Once the video laryngoscope is appropriately inserted, the operator shifts their gaze to the video screen. The laryngoscope is then carefully maneuvered to obtain the best possible view of the glottic opening. As a midline device, a video laryngoscope generally does not require lateral displacement of the tongue, unlike some conventional laryngoscope blades. The view of the glottis is optimized by advancing, withdrawing, or tilting the laryngoscope blade while continuously observing the video monitor. An appropriately positioned video laryngoscope will display a clear image of the glottic aperture on the screen.

Step Three: Introduction Of The Endotracheal Tube

In most instances, the video laryngoscope provides a Cormack-Lehane Grade 1 or 2 view of the glottis. While it may seem intuitive to insert the endotracheal tube (ETT) through the glottic aperture while solely watching the video screen, it is often recommended to maintain the video laryngoscope’s position and momentarily switch one’s gaze from the screen back to the patient’s mouth. The ETT, typically pre-shaped with a stylet to match the curvature of the video laryngoscope blade, is then inserted under direct vision until its distal tip is near the distal tip of the laryngoscope blade. Once this is achieved, the operator’s focus returns to the video screen.

Step Four: Intubation

Viewing the video screen, the operator can confirm the glottic aperture and the ETT’s proximity. Minor adjustments to the blade may be made if necessary. Under video visualization, the ETT is then advanced smoothly along the curve of the blade, through the glottis, and into the trachea. Observing the entire insertion phase on the video screen allows for rapid skill acquisition and facilitates gentle rotation or angling of the tube to redirect it as needed for successful intubation.

What Are Some Intubation Tips When Using A Video Laryngoscope?

To simplify the intubation process with a video laryngoscope, consider the following techniques and tips:

• Stylet Use: Successful placement of the endotracheal tube (ETT) often requires the use of a stylet (e.g., a reusable rigid stylet or a disposable intubating stylet). The stylet provides necessary rigidity and shape to the ETT, preventing it from becoming overly flexible and difficult to navigate through the vocal cords. Note that a stylet is generally not used for nasal intubation.
• Managing ETT Advancement Issues: A common challenge with video laryngoscopy is not necessarily obtaining a good view of the glottis, but rather guiding the ETT through the vocal cords. The tip of the ETT may impinge on the anterior tracheal wall. If this occurs, withdrawing the stylet by approximately 3 to 5 cm can soften the ETT tip, allowing it to advance more easily into the trachea. In some situations, if the ETT still impacts the anterior wall after complete stylet removal, twisting the ETT by 180 degrees can help redirect it.
• Visual Focus During Insertion: It is crucial to look directly into the patient’s mouth when initially inserting the video laryngoscope blade and when introducing the ETT into the oropharynx, rather than focusing solely on the video monitor. This practice helps prevent inadvertent injury to oropharyngeal structures.

What Was The Transition From A Direct To A Video Laryngoscope?

View Video on Laryngoscopy Techniques

For nearly half a century after the introduction of curved and straight laryngoscope blades, the fundamental design of laryngoscopes remained largely unchanged. The first generation of devices that heralded the era of video laryngoscopy were rigid fiberoptic laryngoscopes. Clinicians found these beneficial as they positioned the observer’s viewpoint closer to the glottis, enabling more controlled insertion of endotracheal tubes. However, these early fiberoptic systems were not universally adopted by the anesthesia community, partly because they still required a direct, albeit modified, line of sight.

The true paradigm shift occurred with the integration of video cameras and monitors. This innovation eliminated the need to achieve a direct line of sight, which could be impeded by patient anatomy, external forces, or tissue compression. Video laryngoscopes, however, are generally not as versatile as flexible bronchoscopes for intubation via nasal or tracheostomy routes.

In the late 20th century, the incorporation of a small video chip directly into the laryngoscope blade marked a significant milestone. Following this invention, numerous manufacturers began developing and marketing various designs of video laryngoscopes, leading to the diverse range of devices available today.

What Equipment Do You Need Before You Start Using A Video Laryngoscope On A Patient?

Before initiating a video laryngoscopy procedure, ensure the following equipment and supplies are readily available:

• Personal Protective Equipment (PPE): Gloves, eye protection, gown, and mask
• Syringes (for cuff inflation)
• Video laryngoscope (ensure it is functional and charged/has fresh batteries)
• Endotracheal tubes (ETT) of appropriate sizes
• Sterile water-soluble lubricant
• Stylet (if typically used with the chosen ETT and video laryngoscope)
• Pulse oximeter with appropriate sensors
• Nasogastric tube (if indicated)
• Oxygen source and delivery system
• Bag-valve-mask (BVM) device
• Suctioning equipment with catheters
• Capnometer or CO2 detector for confirming ETT placement
• Backup airway devices (e.g., supraglottic airway device) in case of failed intubation

What Should You Consider When Selecting A Video Laryngoscope?

Choosing the right video laryngoscope involves evaluating several critical factors to ensure optimal performance, patient safety, and user satisfaction:

• Reliability: The device must be dependable. Issues such as inconsistent video quality, unexpected battery failure, or inadequate illumination can compromise intubation success. Anesthesia providers must have confidence in their equipment.
• Ease of Use and Learning Curve: A device with an intuitive interface and a relatively short learning curve is preferable, especially if it will not be used daily. Complex systems may be challenging to operate effectively in emergency situations. Ensure users receive adequate training.
• Image Clarity: A clear, high-resolution view of the airway anatomy is essential for successful intubation. Look for devices with effective anti-fogging technology to prevent lens obstruction and facilitate first-pass success.
• Design (Blade Type):
  • Standard (Macintosh/Miller-like) Blades: These operate similarly to conventional laryngoscope blades, typically requiring a separate stylet to guide the ETT.
  • Channeled Blades: These blades feature an integrated channel to guide the ETT into position. Each design has a different technique and associated learning curve.
• Power Source: Consider whether rechargeable or disposable batteries are more suitable for your clinical setting. Regardless of the type, the device should clearly indicate the remaining battery charge to prevent power loss during a procedure.
• Blade Reusability:
  • Disposable Blades: Offer convenience and eliminate concerns about cross-contamination and reprocessing.
  • Reusable Blades: May be more cost-effective over the long term but require robust cleaning and sterilization protocols and have a defined lifespan.
• Screen Size and Location: Larger screens can improve visualization, but their placement is also critical. Some video laryngoscopes have screens integrated into the handle, while others connect to separate, larger monitors. Consider potential eye strain with smaller screens versus the ergonomic adjustments needed for separate monitors.
• Data Capture: The ability to record and store images or videos of intubations, especially in difficult cases, can be valuable for medical records, quality improvement, and educational purposes.

What Are The Advantages Of A Video Laryngoscope?

Video laryngoscopes offer several significant advantages in airway management:

• Improved Laryngeal Visualization: Frequently provides a superior view of the glottis (often Grade 1 or 2 on the Cormack-Lehane scale) compared to direct laryngoscopy, as it bypasses the need to align the oral, pharyngeal, and laryngeal axes.
• Higher Intubation Success Rates: Particularly valuable in patients with anticipated or encountered difficult airways.
• Minimal Cervical Spine Movement: Reduces the need for neck manipulation, making it a safer option for patients with suspected or confirmed cervical spine injury.
• Less Force Required: Generally requires less lifting force than direct laryngoscopy, potentially minimizing trauma to airway structures.
• Shorter Learning Curve for Difficult Airways: Many clinicians find it easier to achieve successful intubation in difficult airways with a video laryngoscope compared to mastering advanced direct laryngoscopy techniques.
• Effective Teaching Tool: The video output can be displayed on a larger screen, facilitating shared viewing for training and supervision.
• Enhanced Portability and Cost-Effectiveness (Relative to Flexible Scopes): Often more portable and potentially more cost-effective for intubation than flexible fiberoptic bronchoscopes.
• Reduced Hemodynamic Stress Response: Some studies suggest that video laryngoscopy may lead to a less pronounced hemodynamic (e.g., heart rate and blood pressure) response to intubation compared to direct laryngoscopy.

What Are The Disadvantages Of A Video Laryngoscope?

Despite their many benefits, video laryngoscopes also have potential disadvantages:

• Longer Procedure Time (Potentially): In some cases, particularly during the learning curve, the time taken to intubate may be slightly longer compared to proficient direct laryngoscopy in straightforward airways.
• Image Obscuration: The camera lens can be obscured by secretions, blood, or fogging (if anti-fog features are inadequate or fail), hindering visualization.
• Variability in Technique: Different brands and models of video laryngoscopes may require slightly different intubation techniques, necessitating specific training for each device.
• Device Suitability: No single video laryngoscope is universally optimal for all clinical scenarios or patient anatomies.
• Loss of Depth Perception: The 2D video display can lead to a loss of depth perception compared to direct vision.
• ETT Passage Challenges: Even with a good view of the glottis, successfully passing the endotracheal tube through the vocal cords can sometimes be challenging (“view-passage dissociation”).
• Cost Considerations: The initial acquisition cost, as well as ongoing expenses for disposable components or maintenance of reusable parts, can be significant.

What Are The Types Of Laryngoscopy?

Laryngoscopy is a procedure used to examine the larynx (voice box). There are several types:

• Indirect Laryngoscopy: The clinician uses a small mirror held at the back of the throat and a light source to view the larynx. This is a traditional, non-invasive office procedure.

  Indirect Laryngoscopy

• Direct Laryngoscopy: The clinician uses a rigid laryngoscope to gently push down the tongue and lift the epiglottis to directly visualize the larynx. This can be done for diagnostic purposes (e.g., taking biopsies) or therapeutic interventions (e.g., removing foreign bodies or small growths, or facilitating endotracheal intubation).

  Direct Laryngoscopy

• Direct Fiber-optic Laryngoscopy (Flexible Laryngoscopy): A thin, flexible tube with a camera and light source (a flexible endoscope or bronchoscope) is passed through the nose or mouth and down the throat to visualize the larynx and other parts of the airway. Video laryngoscopy, as discussed in this guide, is a form of direct laryngoscopy that uses a rigid or semi-rigid scope with a video camera.

  Direct Fiber-optic Laryngoscopy

What Are The Applications Of A Video Laryngoscope?

Video laryngoscopes have a wide range of clinical applications, including:

• Facilitating Endotracheal Intubation: Their primary use, especially in patients with difficult airways or when administering general anesthesia.
• Diagnosis and Evaluation:
  • Investigating causes of persistent throat or ear pain.
  • Detecting laryngeal injury, airway strictures, or obstructions.
  • Evaluating swallowing difficulties (dysphagia).
  • Identifying causes of voice problems (e.g., hoarseness).
• Teaching and Training: Providing a clear, shared view of the airway for medical education.
• Confirmation of Airway Device Placement: Assisting in visualizing the placement of other airway devices.

What Are The Available Types Of Video Laryngoscopes?

Video laryngoscopes can be broadly categorized based on their design and features. Some common types include:

• Stylet-Type Video Laryngoscopes: These devices often resemble an intubating stylet with an integrated camera at the tip. Examples include the Bonfils, Sensascope, or Rigid and Flexible Laryngoscope (RIFL).

  Bonfils Video Laryngoscope

• Guide Channel Video Laryngoscopes: These devices feature an integrated channel within the blade to help guide the endotracheal tube. Examples include Airtraq and some models of GlideScope or traditional blade designs adapted with channels.

  Airtraq

• Standard Geometry Video Laryngoscopes (Macintosh/Miller-like): These devices have blade shapes similar to traditional Macintosh or Miller blades but incorporate a camera and light source. Examples include the Storz C-MAC, McGrath MAC, and Coopdech VLP-100.

  Coopdech Laryngoscope

What Is A Video Laryngoscope Blade?

A video laryngoscope blade is the component of the device that is inserted into the patient’s mouth to expose the larynx. It typically incorporates a light source (often light-emitting diodes – LEDs) and a miniature video camera near its distal tip. The blade itself can be described by three main parts:

• Spatula: The main flat or curved portion that passes over the surface of the tongue.
• Flange: The side portion of the blade that helps to guide and displace the tongue laterally.
• Tip: The distal end of the blade, designed to lift the epiglottis directly (in straight blades like Miller) or indirectly by being placed in the vallecula (in curved blades like Macintosh).

Video Laryngoscope Blade

What Are The Main Parts Of A Video Laryngoscope?

A typical video laryngoscope system consists of several key components:

• Blades: These can be reusable or single-use and are available in various sizes and shapes (e.g., angulated, straight, curved) to accommodate different patient anatomies and clinical preferences. Some blades have integrated channels to assist ETT introduction. Many feature anti-fog coatings or heating elements to prevent moisture from obscuring the camera’s view.
• Camera and Light Source: A high-resolution miniature camera is located at or near the distal tip of the blade. An integrated light source (usually LED) illuminates the airway for clear visualization.
• Monitor/Display Screen: This can be a stand-alone unit or an integrated screen attached to the laryngoscope handle. It displays the live video feed from the camera. Many systems offer options to record video or capture still images, which can be saved to internal memory or an external drive.
• Handle and Power Source: The handle provides ergonomic grip and houses the power source, which is typically rechargeable or disposable batteries. These batteries power the camera, light source, and monitor. Rechargeable systems usually come with a separate charging unit.

What Are The Available Video Laryngoscope Designs?

Video laryngoscopes come in a variety of designs, catering to different clinical needs and operator preferences. Some common design categories and examples include:

• Blades based on traditional geometry:
  • Curved blades (e.g., Macintosh-style video laryngoscopes)
  • Straight blades (e.g., Miller-style video laryngoscopes)
• Angulated or Hyper-angulated Blades: Designed to provide an improved view around the curvature of the oropharynx (e.g., GlideScope, some C-MAC D-Blade variations).
• Channeled Blades: Incorporate a guide channel for the endotracheal tube (e.g., Airtraq, King Vision channeled blade).
• Rigid Stylet-like Designs: Devices that function more like a video stylet (e.g., Bonfils).
• Specialized Designs:
  • Oxyscope: Designed to allow oxygen insufflation during laryngoscopy.
  • Anterior Commissure Laryngoscope: Specialized for better visualization of the anterior commissure.
  • Bullard Laryngoscope: Anatomic rigid fiberoptic laryngoscope (though earlier versions were fiberoptic, some newer iterations might be video-based).
  • Truview Laryngoscope: Offers an optical lens system and can be connected to a video source.

This list is not exhaustive, as new designs and modifications continue to emerge in the field.

What Is A Glidescope?

A GlideScope is a brand name for a type of video laryngoscope characterized by its hyper-angulated blade. It typically features a rigid plastic or metal blade with a significant upward curve towards the distal tip. A high-resolution camera and an LED light source are embedded near the tip of the blade. The GlideScope system usually includes a reusable video monitor that connects to the laryngoscope handle/blade assembly. It is designed to provide an improved view of the glottis, particularly in difficult airway situations, without requiring direct line-of-sight alignment.

GlideScope

What Are Some Airway Management Pointers When Using A Video Laryngoscope?

Effective airway management using a video laryngoscope involves more than just the device itself. Key considerations include:

• Thorough Airway Assessment: Always conduct a comprehensive preoperative airway examination to identify potential difficulties and plan accordingly.
• Strategic Approach: Whenever possible, avoid “cannot intubate, cannot ventilate” (CICV) scenarios by having a clear primary plan and backup strategies.
• Adherence to Guidelines: Follow established difficult airway algorithms, such as those developed by the American Society of Anesthesiologists (ASA) or other relevant professional bodies. These structured approaches ensure that patients with airway management challenges receive systematic, high-quality care.
• Device Familiarity: Be thoroughly familiar with the specific video laryngoscope model being used, including its setup, operation, and troubleshooting.
• Team Communication: Ensure clear communication within the airway management team, especially during challenging intubations.

What Are Some Possible Complications Following A Video Laryngoscope Procedure?

While video laryngoscopy is generally safe, potential complications, similar to those with direct laryngoscopy, can occur. These may include:

• Minor Trauma: Sore throat, pain or swelling in the mouth, tongue, or pharynx.
• Dental Damage: Chipping, loosening, or dislodgment of teeth, especially if excessive force is applied or if dentition is poor.
• Soft Tissue Injury: Lacerations or abrasions to the lips, tongue, pharyngeal wall, or laryngeal structures.
• Bleeding: Minor bleeding from mucosal trauma.
• Hoarseness: Temporary voice changes due to irritation or minor trauma to the vocal cords.
• Gagging or Vomiting: If airway reflexes are not adequately suppressed.
• Infection: Though rare, particularly if reusable components are not properly decontaminated.
• Esophageal Intubation or Endobronchial Intubation: If tube placement is not accurately guided and confirmed.
• More Serious (Rare) Complications: Laryngeal edema, arytenoid dislocation, or perforation (extremely rare).

Careful technique and appropriate patient selection can help minimize these risks.

Which Patients Are Suitable Candidates For A Video Laryngoscope?

Video laryngoscopes are valuable tools for a broad range of patients requiring endotracheal intubation. They are particularly beneficial for, but not limited to, patients:

• With anticipated difficult airways (e.g., based on Mallampati score, thyromental distance, neck mobility, or history of difficult intubation).
• In emergency settings requiring rapid sequence intubation (RSI).
• Experiencing cardiac arrest or respiratory arrest.
• With suspected or confirmed cervical spine injury, where minimal neck movement is critical.
• In whom direct laryngoscopy has failed or is predicted to be challenging.
• Undergoing procedures in various settings, including operating rooms, intensive care units (ICUs), and emergency departments.

Is It Important To Decontaminate A Video Laryngoscope?

Yes, proper decontamination of reusable video laryngoscope components is absolutely critical. The handle, reusable blades, and any other parts that come into contact with the patient or are exposed to the clinical environment must be thoroughly cleaned and disinfected (or sterilized, according to manufacturer instructions and institutional protocols) after each patient use. This practice is essential to prevent cross-contamination and healthcare-associated infections, ensuring patient safety and maintaining high standards of hygiene.

Single-use (disposable) blades and components are designed to be discarded after one use and do not require decontamination.

How Will You Troubleshoot A Video Laryngoscope?

Effective troubleshooting can resolve common issues with video laryngoscopes:

• Problem: No image appears on the screen after powering on.
  • Solution: Check the battery. Replace disposable batteries or ensure the rechargeable battery unit is adequately charged and properly connected. Verify all cable connections between the blade, handle, and monitor (if separate).
• Problem: The image on the display screen is blurry or unclear.
  • Solution: First, ensure the camera lens at the tip of the blade is clean. Remove the blade (if detachable) and gently wipe the camera lens with a soft, lint-free wipe or as recommended by the manufacturer. Check for condensation (fogging) – ensure anti-fog mechanisms are active or allow time for temperature equilibration if applicable. If the problem persists with a reusable blade, the blade or camera may be damaged and require repair or replacement. If using disposable blades, try a new blade.
• Problem: The light source is dim or not working.
  • Solution: Check battery power. Ensure the blade is correctly connected to the handle, as this often activates the light source. If the problem persists, the light source (e.g., LED) may be faulty, requiring blade replacement or device servicing.
• Problem: Device fails to record or save images/video.
  • Solution: Check if the memory (internal or external card) is full or properly inserted. Ensure the recording function is activated correctly as per the device instructions.

Always refer to the manufacturer’s user manual for specific troubleshooting guidance for your particular video laryngoscope model.

What Are The Challenges Of Using A Video Laryngoscope?

While video laryngoscopes offer significant advantages, users may encounter certain challenges:

• Learning Curve: Although often shorter than for advanced direct laryngoscopy, there is still a learning curve associated with mastering the hand-eye coordination required for video-guided intubation and understanding the nuances of different device designs.
• Skill Degradation for Direct Laryngoscopy: Over-reliance on video laryngoscopy, especially among trainees, could potentially lead to a decline in direct laryngoscopy skills if not practiced concurrently.
• “View-Passage Dissociation”: Obtaining a good view of the glottis on the screen does not always translate to easy passage of the endotracheal tube. Maneuvering the tube into the trachea can sometimes be more challenging than expected (the “can see but can’t intubate” scenario).
• Cost: Video laryngoscopes represent a significant capital investment, and ongoing costs for disposable blades or maintenance of reusable components can be substantial.
• Device Dependence and Availability: Ensuring devices are always charged, functional, and readily available in all necessary clinical areas can be a logistical challenge.
• Image Quality Issues: Secretions, blood, or fogging can obscure the camera lens, compromising the view despite anti-fog features.
• Risk of Oropharyngeal Trauma: If not used carefully, particularly during blade insertion or ETT manipulation, there is a risk of causing trauma to oral and pharyngeal structures. Users must avoid using the video screen as the sole guide when initially inserting the device into the mouth.

Adequate training, ongoing practice, and awareness of these potential challenges are crucial for proficient and safe use of video laryngoscopes.

Other products we offer include video endoscope, EEG electrodes, and EEG Caps.

More Resources:

• Video Laryngoscopes In Intensive Care Unit
• Video Laryngoscopy
• Video Laryngoscopes System

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