The adult Bullard laryngoscope in paediatric patients.
OBJECTIVE
The adult Bullard laryngoscope (BL) is effective in managing both normal and abnormal airways. Although its name implies use in the adult population, its size does not preclude its use in paediatric patients. Thus we evaluated whether the adult BL could be used in the paediatric population and whether its efficacy was related to age, weight, or height.


METHODS
Fifty consecutive patients, between the ages of 1 and 10 years and scheduled for general anaesthesia, were examined. Exclusion criteria included obvious craniofacial abnormalities or indications for rapid sequence intubation. All patients had intravenous access secured before laryngoscopy. The laryngeal view, attempts at intubation, time to intubation and the reason for any difficulty with intubation were recorded. Correlation was then sought relating attempts and time to intubation with age, weight and height.


RESULTS
Mean time to intubation was 38 +/- 13 sec. Multiple attempts occurred most frequently because of right aryepiglottic fold contact or anterior vocal cord contact. The latter appears to be unique to the adult BL use in the paediatric population. No relationship was found between the time to intubation and age, height, or weight. Four tracheas, all in patients < 38 mo, could not be intubated with the BL after four attempts.


CONCLUSIONS
The adult BL appears to be an effective alternative tool in the management of the normal paediatric airway.
Shulman
G B
GB
Department of Anesthesiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, USA.
Connelly
N R
NR
Gibson
C
C
D000328:Adult; D000367:Age Factors; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D004825:Epiglottis / Q000033:anatomy & histology; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods; D020704:Laryngoscopes; D013499:Surface Properties; D013997:Time Factors; D014132:Trachea / Q000033:anatomy & histology; D014827:Vocal Cords / Q000033:anatomy & histology