Abstract

Although direct laryngoscopy (DL) has been the standard of care for endotracheal intubation for over a century, the creation of videolaryngoscopy (VL) could change that practice. Literature boasts of many benefits of VL for intubation of adult patients. However, these conclusions are not appropriately translated to the pediatric patient population. Due to marked differences in pediatric airway anatomy and physiology, the use of VL must be adequately assessed in this specialized population.

A 92.4 kg, 6-year-old male with a body mass index of 47.8 kg/m2 presented to the hospital with tonsillar hypertrophy. The surgical plan included tonsillectomy, adenoidectomy, and bilateral myringotomy with tubes. The patient's medical history included obstructive sleep apnea/snoring, sinus infections, and pneumonia 2 months before surgery. A baseline SpO2 of 92% was noted. After induction of general anesthesia, a Cormack-Lehane grade 1 view was obtained utilizing a McGRATH MAC 3 VL (Medtronic), and the patient was promptly and successfully intubated on the first attempt. No adverse airway events occurred.

The availability of VL provided an optimal view on a patient with a predicted difficult airway, who also was vulnerable to quick desaturation due to several factors. Expeditious intubation on the first attempt is exceedingly valuable as literature reveals that airway management complications can be attenuated by decreasing the number of intubation attempts. For this reason, investigating which method of laryngoscopy provides the highest rate of successful and quick intubation on the first effort is crucial to optimize patient safety.

Olivia Egan

Author Details

Olivia Egan, BSN

Sigma Membership

Unknown

Lead Author Affiliation

Samford University, Birmingham, Alabama, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Literature Review

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Videolaryngoscopy, Direct Laryngoscopy, Pediatrics

Advisor

Herbinger, Lisa

Second Advisor

Haltom, Patrick

Degree

Doctoral-Other

Degree Grantor

Samford University

Degree Year

2023

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2023-02-07

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