Читать книгу Emergency Medical Services - Группа авторов - Страница 91

Video laryngoscopy uses a camera with a view from the end of the laryngoscope blade, providing video images of the airway that are displayed on a screen. Newer generation video laryngoscopes include portable and disposable configurations that are suited to the prehospital setting. While video laryngoscopy has demonstrated equal or improved ETI success rates when compared to traditional laryngoscopy in nearly all clinical settings, its cost is higher than conventional laryngoscopy [27–29]. Some studies suggest that proficiency with video laryngoscopy may be obtained in as few as five intubations [30]. Some video laryngoscopes also allow clinicians to record their efforts for offline review for quality improvement or educational initiatives [31].

Video laryngoscopy technique may be similar to or different from direct laryngoscopy, depending on the specific device. For example, the video laryngoscope blade may be similar to a Macintosh blade, requiring the same approach. In that case, the real‐time advantages of video laryngoscopy are the enhanced perspective and views of airway anatomy and abilities of others to see what the principal operator sees, better enabling them to be helpful. Some video laryngoscopes include angulated blades. Instead of facilitating alignment of airway structures to provide direct visualization, angulated blades follow the resting anatomic contour of the oropharynx to the glottis (Figure 3.4). The patient’s tongue is not manipulated as it is for direct laryngoscopy, and less patient movement or repositioning may be required. A special stylet for the endotracheal tube is generally necessary so that the angle of the blade can be followed. Some curved blades incorporate an integrated channel to direct the endotracheal tube, obviating the need for a stylet.

Figure 3.4 GlideScope^TM video laryngoscope