Disclaimer: The author of this post has no affiliation with the GlideScope manufacturer or it’s affiliates. This is not a paid advertisement.

Over the years of practicing Critical Care Medicine I have seen a lot of gadgets and technologies that were supposed to make our job easier. Many of these technologies simply did not liveb up to their expectations. BIS monitors were supposed to revolutionize sedation in the ICU, yet quickly fell out of favor. Even the technology that was fundamental to the practice of Critical Care Medicine several years ago – pulmonary artery catheterization is fading away.

One piece of equipment that I did find useful in the ICU is the GlideScope. Unless something better is invented for intubation, this technology will stay with us for many years. Intubation in the ICU can become a major disaster fairly quickly. Unlike planned intubations for surgical anesthesia, intubations in the ICU are often performed on unprepared patients (patients with a full stomach) and on the patients in respiratory and hemodynamic distress. Nothing makes me more nervous than a difficult airway in a patient with rapidly dropping oxygen saturation.

The inventors of the GlideScope placed a video camera at the tip of the laryngoscope blade. This allows you to intubate the patient when you cannot get a direct view of the vocal cords. With the Glidescope you get a good view of the vocal cords even if the patient is unable to open their mouth wide. This helps when you are dealing with a difficult airway.

I found a very good educational video (click on the image above) describing the process of intubation with GlideScope step by step. It also gives a good overview of the airway anatomy that is seen with GlideScope.

There is one drawback of using the GlideScope for intubation, though. If the patient is unable to open their mouth wide, you might have a good view of the vocal cords, yet you might not have enough room to manipulate the endotracheal tube and safely introduce it into the trachea. Performing maneuvers described in the video and bending the tip of the endotracheal tube to 60 degrees might help.

If you intubate patients in the Intensive Care Unit, you might want to consider getting a GlideScope.