Abstract
A 29 year old woman, a case of post burn contracture of the neck came for the release. McGrath video laryngoscope was chosen as the initial tool for airway management. Despite an excellent view, intubation failed due to lack of working airway space available after use of video laryngoscope. Successful intubation was achieved with Macintosh laryngoscope although the laryngoscopy view was Cormack and Lehane grade IIIa and percentage of glottic opening score was 25%. More research into the predictors of difficult laryngoscopy or intubation with the video laryngoscope needs to be done before recommending these devices for use in difficult airway scenarios. DOI: http://dx.doi.org/10/4038/slja.v22i2.6833
Highlights
Video laryngoscopes (VLS) are newer equipments that are gaining popularity for use in difficult airway (DA) management
DA cart was checked and surgical team was ready for performing an emergency tracheostomy if required
After achieving adequate depth of anaesthesia, laryngoscopy was attempted with McGrath® video laryngoscope (Aircraft Medical, Edinburgh,UK) (MVL).Cormack and Lehane (C& L)
Summary
Video laryngoscopes (VLS) are newer equipments that are gaining popularity for use in difficult airway (DA) management. They are being used in simulated difficult airway scenarios and in patients with immobilised necks. Airway examination revealed two finger breadth mouth opening (Figure 1), buck teeth, Mallampati Class III, limited neck extension (Figure 2) and thyromental distance of 5cm with perioral scarring. Figure 2: limited neck extension and reduced thyromental distance grade I and percentage of glottis opening (POGO) score of 100% was found. A second attempt was made to improve laryngoscopy but ETT still could not be introduced and there was trauma to the tonsillar pillar by the laryngoscope blade and the bleeding obscured the view. Intubation was possible with a styletted ETT as tongue could be displaced with the ML blade
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