Tips with Glidescope

Some of the students asked me the tips with the glidescope for the anterior airway when I was in clinical the other day. I remember I had struggled with the glidescope for the anterior airway when I first started using it. I had to do some research online to figure out how to get the tube pass the vocal cord with the anterior airway. So here are some of the tips I found online combined with my own experience that I found helpful to deal anterior airway.

1. use the rigid stylet that comes with the glidescope system. Otherwise you won’t be able to pass the tube through the vocal cord with the regular stylet. The angle of the stylet is very important.
2. The common mistake I see when students start to use the video laryngoscope is that they hold the styleted tube in the middle like performing DL. Instead, hold the tube at the very top. When you see the tip of the tube pass the oropharyngeal cavity, you start this slot machine motion to drop the tube to the level almost parallel to the ground. This allows the tip to advance anteriorly towards the vocal cord.
3. The other common mistake I see is that the student gets a perfect view of the vocal cord, but unable to pass the tube. When this happens, you need to pull back a bit. as the camera at the tip is too close to the cord and hence you have little room to maneuver with the tip of the tube.
4. If you still have trouble advancing the tube, cricoid pressure can be helpful as well. You could also try to rotate the tube laterally to the right and then turning it counter clockwise to bring the tip more anteriorly.
5. lastly, if all maneuvers fail, consider repositioning.

I hope you find this is helpful with your glidescope practice.