Difficult laryngoscopy made easy with a "BURP".
Displacement of the larynx by backward, upward and rightward pressure on the thyroid cartilage or "BURP" may improve visualization of the glottis in some cases of difficult direct laryngoscopy. In a patient with the Treacher-Collins syndrome in whom conventional laryngoscopy had proved impossible and tracheal intubation extremely difficult, this manoeuvre exposed the entire glottis and made tracheal intubation under direct vision easy. In a patient with protruding upper incisors and a prominent premaxilla which precluded a view of the glottis by conventional laryngoscopy, "BURP" again revealed the glottic opening and simplified the placement of an endotracheal tube. This experience suggests that "BURP" be considered as a potential aid in the management of difficult direct laryngoscopy.
Knill
R L
RL
Department of Anaesthesia, University Hospital, University of Western Ontario, London, Canada.
D000328:Adult; D002648:Child; D004825:Epiglottis / Q000473:pathology; D005260:Female; D005931:Glottis / Q000473:pathology; D006801:Humans; D007180:Incisor / Q000473:pathology; D007442:Intubation, Intratracheal / Q000379:methods; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D007830:Larynx / Q000033:anatomy & histology; D008310:Malocclusion / Q000473:pathology; D008342:Mandibulofacial Dysostosis / Q000473:pathology; D011312:Pressure; D013957:Thyroid Cartilage / Q000033:anatomy & histology*