What Is The Procedure When Using Video Laryngoscope In Laryngoscopy

What is video laryngoscope?

Video laryngoscopy has revolutionized the conduct of airway management with its improved visualization of the airway structures, especially in difficult intubations. It basically relies on the principle of a video camera embedded on the laryngoscope blade that transmits real-time images to a monitor, thereby providing clinicians with views of the airway structure without the need for alignment of their line of vision with the laryngeal inlet.

What is the preparation as patient before laryngoscopy?

Understanding the procedure: Familiarization with basic steps and the purpose of the video laryngoscope examination reduces preoperative anxiety. You may ask your doctor to explain how each step will be conducted and what sensations you might experience during the process.

Preoperative Instructions The specific preoperative instructions will be provided by your physician. Examples of what may be included are the following: times for fasting and any medications that you may be instructed to take in a prophylactic manner. Follow these instructions very carefully, including being NPO from solids 6-8 hours prior to surgery and stopping clear liquids or other clear concentrates usually 2 hours prior to the surgical time.

Mentally Prepare Yourself: Remind yourself that it is a routine procedure and it is usually not harmful. Deep breathing, meditation, or even listening to music does help in relaxing you.

Risks/Complications: Although rare, the knowledge of complications will aid you in comprehensive preparation. You may ask your doctor about all possible risks and how those risks are managed.

Family Support: On the day of surgery, bring someone with you – a family member or close friend-to keep you company.

What is the preparation as doctor before laryngoscopy?

Double-check the Medical History: Obtain a relevant history from the patient. Highlight any problems with airway management and previous surgery and any complications or difficulties that ensued. Any allergies that might be related or pertinent to material of intubation or pharmaceuticals.

Equipment Check: Check that all equipment is functioning correctly and is appropriately prepared for patients, including but not least the video laryngoscope and in accordance with the needs identified in the patients’ preoperative airway assessment.

Optimal Positioning: It’s important before the procedure that position the patient to optimize airway alignment. The usual ‘sniffing position’ for this involves extension of the head at the atlanto-occipital joint with slight flexion of the neck. However, adjust according to anatomical and medical considerations identified from assessment.

What is the procedure of the Video Laryngoscope Insertion?

Pre-oxygenation: Provide 100% oxygen for several minutes prior to intubation. The superior viewing field accompanying the video laryngoscope tends not to afford extended attempts at intubation, thus drawing upon this oxygen reserve.

Insertion and Visualization: Insertion of the Blade: Insert the video laryngoscope blade with gentle advancement guided by what is viewed on the monitor without attempting to achieve direct line-of-sight as would be the case in conventional laryngoscopy. This minimizes dental trauma and soft tissue injury, complications commonly associated with conventional laryngoscopy.

Advance the Blade and Visualize the Airway: The video laryngoscope camera provides a high-resolution, magnified view of the airway structures for subtle adjustments in an effort to view vocal cords without the physical rough maneuvers required with the older techniques that relied on direct line-of-sight above the airway by the clinician.

Introduce the Endotracheal Tube: The video screen shows a clear track for the endotracheal tube through the vocal cords, guided by the camera. This also significantly reduces the ‘blind spots’ problem common with the use of traditional laryngoscopes and improves the success rate while reducing the possibility of multiple attempts.

Confirm Placement: The screen display of this video immediately provides the most certain visual confirmation of tube placement, giving a second verification in addition to the routine auscultation and capnography common in traditional settings.

Secure the Tube: After the placement of the tube, a visual confirmation is made. Now, it needs to be secured in place. The accidental extubation relating to shifting, which was a necessary evil with the use of the traditional intubation, is reduced with the use of a video laryngoscope.

Continuous Monitoring: It is possible to monitor the patient continuously without the need to look away even after the patient has been intubated. No additional equipment is required to conduct continuous monitoring.

How to clean and disinfect a disposable video laryngoscope after laryngoscopy?

A few procedures are involved in cleaning and disinfection of a disposable video laryngoscope before and after laryngoscopy. Since the blade itself is disposable, these procedures mainly involve the reusable parts, the handle and monitor. The following steps describe how hygiene can be maintained:

Remove and Dispose: Immediately following the examination by laryngoscopy, ensure that the disposable blade is removed with care from the handle of the video laryngoscope. Dispose of it according to protocols in the hospital for medical waste-that most typically requires placing it in a designated sharps container with the planned purpose of preventing needle-stick injury and cross-contamination.

Surface Wipe Down: Using a soft, lint-free cloth moistened with a mild detergent solution, wipe down the handle and other non-disposable parts. This should help in removing any visible debris or organic material from view. Harsh scrubbing should not be performed on the device.

Correct Disinfectant: Proceed with an EPA-registered hospital-grade disinfectant compatible with material of Video laryngoscope. This is of great concern to prevent degradation of plastic and electrical components in the handle and monitor.

Proper Disinfectant Application: Spray or wipe the disinfectant on the handle and monitor but ensure complete coverage. Follow the instructions of the manufacturer regarding the contact time of the disinfection-usually several minutes.

Air dry: After disinfection, allow the handle and monitor to air dry thoroughly. This will ensure that total evaporation of the disinfectant occurs to minimize the risk of an active residue affecting either patient safety or the function of the device.

Inspect for damage: After cleaning, disinfection shall be carried out by visually inspecting the video laryngoscope handle and monitor for any hints of damage or wear that could affect functionality or compromise hygiene.

These are the steps one has to follow in order to clean up, disinfect, and maintain disposable video laryngoscope parts that are reusable, in their quest to make them ready for safe use in upcoming procedures, with due consideration for the standards of infection control.

These are general guidelines for cleaning and disinfecting disposable video laryngoscopes. If you’ve purchased a CoreRay video laryngoscope, detailed instructions on the cleaning and disinfection process, including recommended disinfectants and best practices, can be found in the CoreRay Video Laryngoscope User Manual. [Download the User Manual here]. The manual offers thorough guidance to ensure proper maintenance and adherence to hygiene standards.