The Promoted Myth of Miller Blades only for Kids. Don't believe the Hype. Macs work too.

December 15, 2016

Took the past 12 years to intubate one child. Anesthesia paged to Pediatric ED and I was available to walk over from the Adult Main Ed and assess the situation. One EM pgy 3 resident had failed and the EM attending doing a peds shift had failed as well. The child was sickly and hypoxic. Patient had decompensated from apparent Croup.

I came over and asked what was available, and not pediatric glidescope was at hand. BVM was how the child was being bagged up. So I asked for a blade and I happened to encounter a rare commodity, the size 2 macintosh curved laryngoscopy blade. They had failed with miller blades and I was willing to try something that I use all the time but in a smaller size.

I used the blade how I usually use it. Entered the right side, swept the tongue as I slowly proceeded deeper into the depth of the oropharynx and found the vallecula and found the glottis opening. Went deep to make sure the endotracheal tube was in and then pulled back. Asked what I did. "I did what I do with my other intubations for adult. Did the same thing."




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