Three-dimensional cervical spine movement during intubation using the Macintosh and Bullard laryngoscopes, the Bonfils fibrescope
and the intubating laryngeal mask airway.
consists of three main parts: the handle, insertion cord and the light source (Figure 2).
An important detail of the latter study is that in 22% of all intubations, the initial attempt at intubation was performed by the most experienced physicians using a fibrescope
or a Glidescope[R] (Verathon Medical, Rennerod, Germany).
was then used to verify the positions of the ETT and the balloon (Figure 4).
An adult fibrescope
was not available at that time.
Patients in whom PLMA placement was considered successful after clinical testing were examined using a Tracheal Intubation Fibrescope
(Olympus LF-T, Japan) through the airway tube of the PLMA at a position of 1 cm proximal to the end of the tube and the view was graded using a system modified from that suggested by Brimacombe and Berry (5): Grade 4=only vocal cords visible, Grade 3=vocal cords and posterior epiglottis visible, Grade 2=vocal cords and anterior epiglottis visible and Grade 1=vocal cords not seen.
The intubating fibrescope
(Olympus LF-GP, Olympus America Inc.
comes with a suction channel that can be used for administration of local anaesthetic under direct vision as well as oxygen insufflation if necessary.
We suggest using a normal adult endotracheal tube with a Murphy eye for initial training in the control of the rotation of the fibrescope
The simulator provides excellent realtime video of the tracheobronchial tree, down to the level of segmental bronchi and the user controls and directs the fibrescope
into the airway of interest.
1 mm OD fibrescope
(Olympus LF-GP; Olympus Optical, Tokyo, Japan) was passed orally to intubate the trachea.
In this descriptive study a fibrescope
was used to assess the site and mechanism of tracheal tube impingement during advancement over a variety of fibreoptic bronchoscopes and introducers during orotracheal intubation in anaesthetized adults.