Video Laryngoscopes – Modern Standard Instruments in Anesthesia and Emergency Medicine
In recent years, video laryngoscopes have become a key tool for airway management. They offer a significantly improved view of the laryngeal structures, thus increasing the likelihood of successful endotracheal intubation – especially under difficult conditions.
Design and Components
A video laryngoscope essentially consists of the following components:
- Blade: Is inserted into the oral cavity to push the tongue aside and provide a view of the glottis.
Common variants include:
- Macintosh-style blade – allows both direct and indirect viewing
- Hyperangulated blade – specifically for difficult airway management
- Miller blade – preferred in neonatal care; see also Overview of Blade Types - Camera: A miniature camera at the tip transmits live images to the screen.
- Illumination: An integrated LED ensures even illumination of the airway.
- Monitor: The image appears on a separate or integrated screen, thus supporting precise tube insertion.
Typical Applications
Video laryngoscopy is used in various clinical situations, especially in:
- Routine intubations: The procedure has increasingly become standard, especially in anesthesia.
- Difficult airways: According to the S1 guideline, primary use is recommended here.
- Emergencies: The better overview increases the chances of success in critical intubations. Education and
- Training: Since the image is visible to several people simultaneously, the technology is ideal for training physicians.
Guidelines and Scientific Data
The current S1 guideline "Airway Management" of the German Association of the German Society of Cardiovascular Infection (DGAI) recommends the routine use of video laryngoscopes. Key messages are:- Devices with a Macintosh-like blade can be used as a first-line instrument.
- Hyperangulated blades should be available for anticipated difficult intubations.
- After a failed direct laryngoscopy, video laryngoscopy is the recommended procedure.
- In cases of high risk, it is the preferred method.
Video laryngoscopes have fundamentally changed the practice of airway management. They offer decisive advantages in complex situations, are well-supported by studies, and are increasingly becoming standard practice. However, targeted training of medical personnel remains a prerequisite for safe use.