title: Novel Use of Glidescope Indirect Laryngoscopy for Insertion of a Minnesota Tube for Variceal Bleeding.
abstract: BACKGROUND
  With improvements in endoscopic and interventional radiologic therapies, insertion of gastroesophageal balloon tamponade catheters, commonly known as Sengstaken-Blakemore or Minnesota tubes, is a rarely performed procedure for esophageal or gastric variceal bleeding. In small hospitals or freestanding emergency departments, endoscopic or interventional radiology (IR) therapies might not be available, so patients with exsanguinating variceal bleeding must be stabilized or temporized for transport to larger hospitals. Occasionally, tamponade devices are necessary as a rescue therapy for failed endoscopic or IR therapies or can be used as definitive therapy in select cases. In addition to being rarely performed, there are multiple technical complications associated with blind insertion of tamponade catheters.
  
  
  CONCLUSIONS
  We describe a novel use of indirect laryngoscopy using a Glidescope for assisting in placement of a Minnesota tube in 4 patients with exsanguinating esophageal bleeding.
  
  
  CONCLUSIONS
  Insertion of a Minnesota tube for bleeding esophageal or gastric varices is an uncommon, technically challenging procedure that can be lifesaving, and is something emergency physicians, intensivists, and gastroenterologists should be capable of performing. Addition of indirect laryngoscopy may help to improve rapid, safe, and successful placement of these devices.
authors.affiliation: Departments of Emergency Medicine and Internal Medicine, Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Schlichting
authors.affiliation: Departments of Emergency Medicine and Internal Medicine, Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Jayna M
authors.initials: JM
authors.lastname: Gardner-Gray
authors.affiliation: Departments of Emergency Medicine and Internal Medicine, Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Gina
authors.initials: G
authors.lastname: Hurst
mesh_terms: D021721:Balloon Occlusion; D002404:Catheterization / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D006801:Humans; D007828:Laryngoscopy / Q000295:instrumentation / Q000379:methods*
keywords: Minnesota tube; indirect laryngoscopy; procedure; tamponade; varices