Laryngoscope

1. LARYNGOSCOPE

2. INDICATIONS In Infants Prior to endotracheal intubation in: Neonatal asphyxia Meconium aspiration Respiratory distress syndrome Tracheo oesophageal fistula Mechanical ventilation

3. . In Older Children Prior to endotracheal intubation: Resuscitation During admoinistration of general anaesthesia Epiglottitis Kerosene poisoning Direct Laryngoscopy In cord palsy Anatomical lesions Foreign body

4. Contraindications Diseases or injuries of cervical spine. Moderate or marked respiratory obstruction.

5. PROCEDURE Gauze piece placed on upper teeth to protect against trauma. After lubrication, the laryngoscope is held by the handle in the left hand. Right hand is used to retract the lips and guide the scope. It is introduced by one side of the tongue which is pushed to the opposite side till posterior third of tongue is reached. It is advanced behind the epiglottis and lifted forward without levering it on the upper teeth or jaw

6. Following structures are examined serially: Base of tongue Right and left valleculae Epiglottis Right and left pyriform sinuses Arypeiglottic folds Arytenoids Post cricoid region False cords Anterior and posterior commissure Ventricles and vocal cords Subglottic area

7. Complications Mechanical injury injury to local tissues like teeth,tongue,palate Stimulation of posterior pharyngeal wall may cause vago-vagal episode leading to hypoxia, bradycardia . Hyperextension of neck may cause damage to cervical spine.