Pediatric laryngoscopes and intubation aids old and new.
This review summarizes the evolution of the pediatric laryngoscope using some of the established landmarks in the history of anesthesia. Children were rarely intubated before 1940 though the subsequent 30 years saw a proliferation of pediatric laryngoscopes in part driven by the developments in pediatric anesthesia and surgery, manufacturing techniques and materials and a change in airway management philosophy exemplified by Jackson Rees's argument against the notion that intubation was to be avoided in children. A perspective on the present day describes the modifications to popular straight and curved blade laryngoscopes and the development of new devices that enhance direct visualization of the larynx. There are an ever-increasing number of laryngoscope devices that assist in indirect visualization of the larynx such as rigid optical stylets and flexible fiber-optic scopes. Images from many of these devices may be enhanced by digital camera or real-time video technology. The prospect of future laryngoscope development is glimpsed in the arrival of light emitting diode light source technology and questions remain regarding the consequences of equipment disposability and at the fidelity of disposable equipment manufacture.
Doherty
Jane S
JS
Department of Anaesthetics and Intensive Care Medicine, University Hospital of Wales, Cardiff, UK. janes.doherty@virgin.net
Froom
Stephen R
SR
Gildersleve
Christopher D
CD
D000777:Anesthetics / Q000266:history; D002648:Child; D004209:Disposable Equipment; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D007442:Intubation, Intratracheal / Q000266:history* / Q000295:instrumentation / Q000639:trends*; D020704:Laryngoscopes / Q000266:history* / Q000592:standards / Q000639:trends*; D007828:Laryngoscopy / Q000266:history* / Q000592:standards / Q000639:trends*; D008027:Light; D009125:Muscle Relaxants, Central / Q000266:history; D055100:Optical Fibers
D000777:Anesthetics; D009125:Muscle Relaxants, Central