Reuben Strayer: Leisurely Laryngoscopy (SMACC DUB)

• Position

• • head at head of bed, or beyond (occiput off)

  • ear to sternal notch

  • head of bed up

  • • Levitan RM, Mechem CC, Ochroch EA, Shofer FS, Hollander JE. Head-elevated laryngoscopy position: improving laryngeal exposure during laryngoscopy by increasing head elevation. Ann Emerg Med. 2003;41(3):322-30.

  • look into the mouth; not get into the mouth

• Start laryngoscopy early (but with deliberated slowness)

• Incremental Goal Directed Tracheal exposure (IGDT)

• • lead with suction

  • soft palate → uvula → posterior wall → epiglottis → interarytenoid notch

  • ELM (external laryngeal manipulation)

• Eschmann Introducer (Gum Elastic Bougie)

• Assistant

• • 拉嘴角

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