C-MAC

            Video and optical laryngoscopes combine a tongue retractor (blade) with an imaging mechanism to achieve endotracheal intubation. Designs vary significantly in terms of blade design, imaging mechanisms, and the method of tube delivery.

            The Storz C-Mac is a portable, battery operated, video laryngoscope that resembles a standard Macintosh blade. The intubation technique is identical to conventional Macintosh laryngoscopy with the additional aid of a magnified video view. The C-MAC is a modification of the Karl Storz Berci DCI® Video Laryngoscope. Previous investigations have found that device useful in operative airway management, as an instructional tool, and in simulated prehospital environments.

          The key innovation delivered with the new C-MAC is the availability of a fully portable video-laryngoscopy set-up featuring improved image quality. Additional differences to the DCI system include improved optics, improved field of view, improved interface for adjusting video quality, and easy recording of still pictures and motion video. These changes allow high-end video laryngoscopy in potentially challenging airways and in expanded scenarios such as ICU, emergency medicine, or prehospital airway management.

 

The C-Mac offers different blade options to improve visualization.

 

The D-BLADE, looks promising to advance the state of the art even further. This blade is more curved than most video laryngoscope blades, which is supposed to bring the vocal cords into view more easily.

 

 

Glidescope

          The GlideScope is a device that incorporates a small video camera for an indirect, live view of the glottis on a video screen.

          The GlideScope GVL is recommended for children 1.5-20 kg. GlideScope GVL blades come in sizes 2, 3, 4, and 5.

 

*The following Pros & Cons are in comparison to standard direct laryngoscopy techniques.

 

GLIDESCOPE PROS

• NO absolute contraindications for its use

• Less mouth opening needed for glottic view

• Minimal cervical spine manipulation needed

• 60° angle view of the glottis without requiring alignment of the oral, pharyngeal and tracheal axises and no additional lifting force needed

• Reduced intubation failure rate than direct laryngoscopy

 

GLIDESCOPE CONS

• Not always available

• Cost $$$$$

• Technical challenges in passing ETT despite excellent view of cords

• Requires coordination of eyes on screen and hands on blade, atypical from traditional DL

• Not a direct view

• Relative contraindication in mouth opening <3cm

• Not gold standard for difficult airway management

• Facial trauma, tumors, abscesses, and neoplasms of the upper airway may inhibit blade insertion