Recently I’ve seen more and more medics utilizing video laryngoscopes during their intubation attempts. And let me ask you a question: why? Is it because you don’t have faith in yourself? You should! You’re a paramedic! The greatest healthcare provider on planet earth, if I’m any example!
Some people will say that these video scopes have higher first pass success rate, but who is gathering this information? Because I’ve never succeeded with one. And I doubt you have either. I’ve seen you all in the field and trained half of you in class. There’s no way you’re succeeding in intubation after what I’ve taught you.
It’s the corporate interests that are fabricating these numbers so they can sell more fancy scopes. But the greatest intubation success will always be the digital method.
What’s that? You’ve never heard of digital intubation? You think it’s old-fashioned, out-dated, poorly-taught skill that was left behind decades ago? That’s only because you’ve never had anyone explain it to you properly.
So let me break it down to you in a series of steps:
- Gather your equipment. You’ll need a endotracheal tube. Nothing else. No capnography. No stethoscope. No syringe. This technique is a guaranteed first pass success when used correctly.
- Open the patient’s mouth. You can do this by grabbing their mandible (the lower jaw) and yanking harshly downward and inward. This creates the maximum amount of space inside their oropharynx.
- Position the tube in a solid grip with the cuff facing upwards. This is known as the Blaggenmeister Grip, after Albritcht Blaggenmeister, a notorious German serial killer who refined many early intubation practices.
- Insert your whole hand into their mouth. This is easy for me since a severe pediatric disease left me with hands the size of a five year old midget’s. If you have larger hands, apply more leverage on the jaw to create an adequate opening.
- Locate the epiglottis flap. It’ll feel like a rubbery seal if you’re not using gloves, which you shouldn’t be for this procedure.
- Begin insert the tube with the cuffed end going first. Once it is rooted in the tracheal opening, begin forcefully advancing your fingers alongside the tube until you can feel the cricothyroid rings.
- Continue to advance until your elbow is adjacent to the patient’s teeth.
- Locate the carina with your middle finger and push the end of the tube down a main stem. This will secure it in place so it can’t fall out.
- Ventilate the patient as normal.
Using this technique, you’ll have 100 percent success rate and we can get rid of the harmful video laryngoscopy once and for all.
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