Tips and tricks for intubation with the video laryngoscope
From airway management experts Dr Jim DuCanto and Dr Johannes Huitink
This exclusive video series offers valuable, practical tips on endotracheal intubation with the video laryngoscope, featuring the HEINE visionPRO.
Leading experts and trainers demonstrate various techniques from clinical practice and show how even small adjustments can contribute to safe and effective airway management. The videos are aimed at healthcare professionals who want to improve their skills in using the video laryngoscope.
Intubation tips by Dr Jim DuCanto
Dr Jim DuCanto, an anaesthesiologist and a trainer in airways management (S.A.L.A.D. technique), provides tips for performing endotracheal intubation with the HEINE visionPRO video laryngoscope. Even minor adjustments in approach make a difference. Here are some techniques that can make intubation easier in specific situations.
#1 Opening the mouth with a tongue-blade holder for better control of the tongue
This technique can simplify endotracheal intubation, particularly in patients with an enlarged tongue (for various reasons). A tongue-blade holder is used instead of the often used ‘scissor’ technique, which does not sufficiently secure the tongue at the bottom of the mouth.
#2 Precisely positioning a video laryngoscope with two hands
In this intubation technique, Dr DuCanto uses both hands for maximum fine-tuning and control. One hand holds the laryngoscope, while the other grips the flange of the blade to ensure precise insertion and correct positioning of the blade.
#3 Rotation technique for the endotracheal tube
Sometimes, inserting the endotracheal tube using a bougie can be difficult, as it may catch on the laryngeal cartilage. Using the ET tube rotation technique supports successful intubation in such cases.
#4 Intubation with a pre-prepared bougie
This alternative technique involves preloading the ET tube onto the bougie in advance, which can make intubation without assistance easier or save crucial seconds in an emergency. A ‘loop’ is formed for compact handling.
#5 What should you do if the camera is contaminated?
If bodily fluids suddenly obstruct the camera view, there are two ways of rapidly resolving this unexpected situation with the visionPRO video laryngoscope: either switch to direct laryngoscopy or rapidly replace the single-use blade with a new one.
Intubation tips by Dr Johannes Huitink
Dr Johannes Huitink is an airway management expert and Fellow of the European Airway Management Society. He founded the Airway Management Academy in the Netherlands in 2013. The academy is a non-profit global network of inspiring airway educators.
www.airwaymanagementacademy.com
#6 Suction Catheter Assisted Tracheal Intubation (SCATI)
How to do a tracheal intubation using a suction catheter and a video laryngoscope? The procedure can be helpful in critical situations where the patient urgently needs a secure airway to enable ventilation.
#7 EMG Tube Intubation with the video laryngoscope
An EMG tube (Electromyographic Endotracheal Tube) enables monitoring of the vocal cord function and potential nerve damage during surgery. A video laryngoscope can support the correct placement of this special tube and make it visible for the entire operating team.
#8 Face-to-Face Intubation
This technique is particularly useful in situations with limited or no access behind the patient's head, covering a wide range of prehospital scenarios. The technique is also referred to as Tomahawk intubation since the laryngoscope is held in a similar way.
#9 Video Laryngoscopy Assisted Flexible Intubation (VAFI)
How to master a difficult intubation by combining a video laryngoscope with a flexible bronchoscope? VAFI is a dual camera rescue technique to be used if visibility with the video laryngoscope is given but the tube cannot be inserted around a curve.
#10 How a Checklist App Can Improve Patient Safety
This video presents a video-assisted Airway Triage checklist and explains its advantages for healthcare professionals in any clinical situation where airway management is required.
The checklist ‘Airway Triage’ is available as an app for iPhone* and Android*. The app was designed by the Airway Management Academy.
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Disclaimer:
Intubation is a complex medical procedure that must be performed by trained medical professionals with the necessary expertise. The method and procedure shown may vary depending on the specific medical products and the individual needs of the patient. Always follow the relevant user manual and your establishment’s protocols and guidelines for intubation procedures.