Intubation question

[d_miracle36]

Ok on my first field intubation I used a mac blade on a pt with a short large neck and got it just fine. My second I used a Mac on a skinny long neck, couldn't visualize anything, switched to a miller and saw the landmarks just fine. What is the best way to chose the right blade before you attemp intubation, or is there any?

 

[Shishkabob]

Experience.


Every patient is different. What will work on one long skinny neck of one patient might not on a long skinny neck of the next. Most providers have a "go-to" blade that they use most of the time, and only switch to something else when that one doesn't work. It's ok to have a 'go-to' blade, but from time to time, use the other style as well, because you never know when you might need a Mac instead of a Miller, and will need to be able to use it without skipping a beat.



Only way to tell for sure which blade will work for a specific patient is to stick it in and see if it works.

 

[Nervegas]

King airway!!!!

I kid, basically what Linuss said, I personally grab a Mac 4 to start and will switch as needed.

 

[MSDeltaFlt]

There are those who only use a certain style of blade. And then there those who know how to intubate.

Know your airawys. Was that pt a grade 1, 2, 3, or 4? To really know for sure that pt had to have been properly positioned. Remember, you're still learning. As are the rest of us. Keep learning, my friend. You'll get it down pat.

 

[MedicPatriot]

I pretty much maintain neutral alignment, insert into the corner and displace tongue. Usually I won't have enough room to advance the blade so I have to tilt the head back just enough to slide the blade in. Blade under the epiglottis and usually I just lift forwards or let go of the head and that usually is enough weight. I don't know how else to describe it but it worked great for me.

I used to have the same troubles. I think I used to just go too shallow or too deep back in the day. That and I didn't lift to the feet. Thats important. Lifting up is no good. You need to lift towards the feet of the patient.

To me, Miller is for pediatrics.

I guess I'm lucky because if I don't see anything, I can bust out the Glidescope Ranger.

 

[usafmedic45]

What is the best way to chose the right blade before you attemp intubation, or is there any?

#11 blade.