Reducing injury during video-assisted endotracheal intubation: the "smart stylet" concept.
OBJECTIVE
Video-assisted endoscopic intubation (VAEI) has gained wide use in anesthesiology when difficult intubation is encountered. Even when excellent visualization of the larynx is achieved with VAEI, successful intubation can be difficult and/or traumatic due to awkward angles and rigid stylets. Presented is a modification of standard VAEI procedure that allows for minimization of intubation trauma.


METHODS
Technical description of VAEI with "smart stylet" for laryngeal surgical patients.


RESULTS
For difficult intubations, a GlideScope™, a type of VAEI, is used in combination with a flexible bronchoscope acting as a "smart" stylet. The bronchoscope is not used for its light or fiberoptic capacity, but rather as a manipulatable stylet for the endotracheal tube. The technical description of this technique is presented with illustrative images and online video content.


CONCLUSIONS
The "smart stylet" concept allows for successful and safe endotracheal intubation when used with the Glidescope™.
Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, The University of Washington School of Medicine, Seattle, Washington 98195, USA. p.weissbrod@gmail.com
Philip A
PA
Weissbrod
Albert L
AL
Merati
D020680:Bronchoscopes / Q000009:adverse effects; D004867:Equipment Design; D004869:Equipment Safety; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation*; D007830:Larynx / Q000293:injuries*; D014741:Video Recording / Q000295:instrumentation*