I am not an expert on this. But what I was told, if you don't do this much, here are the tricks:
1.)make sure the video camera part is centered very STRAIGHT in the mouth, it's easy to be off left or right, make sure the video is very centered.
2.)bend your stylet exactly like the video camera looks and just put it in. While the camera is to be centered in the middle well, the tube comes in from the side
3.)if you know you are about to use it, quickly check out this video on youtube 1st
I appreciate seeing the usefulness of the GlideScope; however, I feel it is useless if the ETT is not at the ready for insertion once the cords are visualized. The last pt in particular was w/out ventilation for too long, regardless of probable preoxygenation. In pre-hospital EMS, it is imperative that all equipment be ready prior to insertion. Although VS may show no immediate change, we can all appreciate how even 20 sec w/out oxygen can be stressful on our systems.
ive always preffered for the epiglottis to be lifted as well (mac 4), with this it looks like u have to put alot of cricoid pressure to get a good view
Actually, in my experience, cricoid pressure / external laryngeal manipulation is rarely needed with the GlideScope, even with patients with a fairly anterior larynx that would be difficult to intubate using a Mac or Miller blade. My memory is that none of these posted videos required cricoid pressure / external laryngeal manipulation. John Doyle
This video is incredible, I go to it in my Paramedic classes each time I teach Airway Management. It is a great tool to use when identifying landmarks and demonstrating what the students will see in real intubations. The students love it. Thanks...
John, Has anyone noticed the movement of the endotracheal tube as the stylette is removed or rotated? The ETT will move upward and foward as the stylette is retracted. If you are beneath the glottis this trick will bring the tube right to the glottic opening. If you were to the left and below you then only need to rotate your tube 45 degrees clockwise and retract the stylette.
Dr. Micheal Smith (Cleveland, Ohio) has formally studied this issue, and presented his analysis at the ASA meeting last October. He has also invented a device to take advantage of this effect. Hope this helps. John Doyle
neat. please post more if and indeed they become available. it's appreciated. but, with the way some of those et tubes were working the glottis, i just might have confused this video for a certain 1972 pornographic film.
In case C10 the patient does not seem to be fully relaxed, he's also coughing when the tube is passed down the pharynx, so he seems to be too less anasthezized for intubation, that shouldn't even happen in rapid sequence induction...
Case C13: Why upload the epiglottis??
And there are alot of possible luxations of the Cartilagines arytenoideae to see in this vid too...
Either case C10 was an awake intubation (I have done a series of these) or muscle relaxation was imperfect (more likely). In case C13 the epigottis was lifted out of the way - an acceptable but often unnecessary step.
I didn't want to come out and acuse the clinician's of being inexperienced, but that was my suspicion. I was not able to convince myself that they were technically proficient, actually thought they were students. Still it's a great video and I am glad that you posted it. Thank you for being candid and in sharing the limitations of this device.
In case C-7, was that a traumatic introduction of the Glidescope during the intubation, or was there another etiology for the small amount of bleeding during the procedure? The overall video was fantastic, I'm assuming that the "poking" around with the ET tubes in a few of the cases was intentional for pointing out anatomical structures, and not because of difficulty in the insertion. Is this product for pediatric and adult patients?
It turns out that the "poking around" is a reflection of the inexperience of the operator. Experience shows that the principal limitation in using the GlideScope is not in getting a good view of the glottis, but rather in manipulating the endotracheal tube (ETT) through the vocal cords.
Yeah, this is really fantastic! You can read about it all day long, but you really don't know what it looks like on a real person until you do it. This video rocks!
I am not an expert on this. But what I was told, if you don't do this much, here are the tricks:
1.)make sure the video camera part is centered very STRAIGHT in the mouth, it's easy to be off left or right, make sure the video is very centered.
2.)bend your stylet exactly like the video camera looks and just put it in. While the camera is to be centered in the middle well, the tube comes in from the side
3.)if you know you are about to use it, quickly check out this video on youtube 1st
frmertd 1 year ago
Thank you for taking the time and posting these.
thegaspasser2000 1 year ago
Some of those are awfull the one with the bleeding j thought was atrosious!
minileafe 1 year ago
слюнявые глотки...офигеть!
toni7777ful 1 year ago
WTF? im scared of surgery now!!!!
larsaris 1 year ago
That last insertion must have been done by a trainee.
OmegaWolf747 2 years ago
can't hear it
pahammond1 2 years ago
Oh Lord, these don't look pretty at all... I'm surprised they didn't remove the coloured mucus first...
army4evr 3 years ago
wow!! big time aspiration on case 6
talfonso4 3 years ago
you are right! I was surprised! He should have first remove the secretions!
macsuta 3 years ago
I appreciate seeing the usefulness of the GlideScope; however, I feel it is useless if the ETT is not at the ready for insertion once the cords are visualized. The last pt in particular was w/out ventilation for too long, regardless of probable preoxygenation. In pre-hospital EMS, it is imperative that all equipment be ready prior to insertion. Although VS may show no immediate change, we can all appreciate how even 20 sec w/out oxygen can be stressful on our systems.
thatellen 3 years ago
if correctly preoxygenated a patient can last up to 9 minutes without ventilation.
gbthorn77 2 years ago
gross just shoved that booger right into the lungs
CuriousJerk 3 years ago
Why is one of them bleeding?
papaverineperoxide 3 years ago
If I recall correctly, the patient had radiation for laryngeal cancer and his tissues were very friable.
djdoylemd 3 years ago
nice.......
tongsaa 3 years ago
Would like to a version of this for neonates, if anyone uses a glidescope( or if its available)
totalcheeseball 3 years ago
Wonderful video for the live demostration. Please make it available to all
drmohsinchisti 3 years ago
I thought that I WAS making it "available to all" by uploading it to YouTube.
djdoylemd 3 years ago
ive always preffered for the epiglottis to be lifted as well (mac 4), with this it looks like u have to put alot of cricoid pressure to get a good view
cjvaldez05 4 years ago
Actually, in my experience, cricoid pressure / external laryngeal manipulation is rarely needed with the GlideScope, even with patients with a fairly anterior larynx that would be difficult to intubate using a Mac or Miller blade. My memory is that none of these posted videos required cricoid pressure / external laryngeal manipulation. John Doyle
djdoylemd 4 years ago
This video is incredible, I go to it in my Paramedic classes each time I teach Airway Management. It is a great tool to use when identifying landmarks and demonstrating what the students will see in real intubations. The students love it. Thanks...
Do you have any others posted like this.
jsayles70 4 years ago
We use this thing in Heidelberg, too. It´s agreat help!
MAnuciao79 4 years ago
John, Has anyone noticed the movement of the endotracheal tube as the stylette is removed or rotated? The ETT will move upward and foward as the stylette is retracted. If you are beneath the glottis this trick will bring the tube right to the glottic opening. If you were to the left and below you then only need to rotate your tube 45 degrees clockwise and retract the stylette.
imakeunumb 4 years ago
Dr. Micheal Smith (Cleveland, Ohio) has formally studied this issue, and presented his analysis at the ASA meeting last October. He has also invented a device to take advantage of this effect. Hope this helps. John Doyle
djdoylemd 4 years ago
John, Thank you for the information.
Paul Safara, CRNA
Haley Veterans Administration Hospital, Tampa, Florida
imakeunumb 4 years ago
lidocane spray
dean830 4 years ago
neat. please post more if and indeed they become available. it's appreciated. but, with the way some of those et tubes were working the glottis, i just might have confused this video for a certain 1972 pornographic film.
Wondahboy 4 years ago
Really a great video! Thanks for posted this!
Bodereca 4 years ago
Why is this video flagged as "inappropriate for some users?" Are there any pansies around here?
DoctorDeath112 4 years ago
Good question! A case of bad judgement, I would guess. Or maybe someone thought that they were looking at the cervix instead of the glottis.
John Doyle
djdoylemd 4 years ago
ROFL! Yeah, maybe so! Nice footage, though! Very clear pictures...
Greetz
Chris
(German EMT-P, EMS instructor)
DoctorDeath112 4 years ago
Yes I agree... I wish i knew about this video when we were learning to tube. It really points out a lot of features of difficult intubations.
Jphoffman0 4 years ago
Great teaching vid. But I have some remarks:
In case C10 the patient does not seem to be fully relaxed, he's also coughing when the tube is passed down the pharynx, so he seems to be too less anasthezized for intubation, that shouldn't even happen in rapid sequence induction...
Case C13: Why upload the epiglottis??
And there are alot of possible luxations of the Cartilagines arytenoideae to see in this vid too...
Nevertheless it's great teaching material!
Larynxmaske 5 years ago
Either case C10 was an awake intubation (I have done a series of these) or muscle relaxation was imperfect (more likely). In case C13 the epigottis was lifted out of the way - an acceptable but often unnecessary step.
John Doyle
djdoylemd 5 years ago
I didn't want to come out and acuse the clinician's of being inexperienced, but that was my suspicion. I was not able to convince myself that they were technically proficient, actually thought they were students. Still it's a great video and I am glad that you posted it. Thank you for being candid and in sharing the limitations of this device.
ihavenoscruplez 5 years ago
In case C-7, was that a traumatic introduction of the Glidescope during the intubation, or was there another etiology for the small amount of bleeding during the procedure? The overall video was fantastic, I'm assuming that the "poking" around with the ET tubes in a few of the cases was intentional for pointing out anatomical structures, and not because of difficulty in the insertion. Is this product for pediatric and adult patients?
ihavenoscruplez 5 years ago
It turns out that the "poking around" is a reflection of the inexperience of the operator. Experience shows that the principal limitation in using the GlideScope is not in getting a good view of the glottis, but rather in manipulating the endotracheal tube (ETT) through the vocal cords.
John Doyle
djdoylemd 5 years ago
Yeah, this is really fantastic! You can read about it all day long, but you really don't know what it looks like on a real person until you do it. This video rocks!
connah0047 5 years ago
one of the best teaching tools I've seen. Thanks!
plach72 5 years ago
Great vid
charlestodd3 5 years ago
awesome video.
nremtdan 5 years ago
im doing intubation now in school and this really helps putting it into perspective.
EMTABA 5 years ago