A laryngoscope is an illuminating medical instrument used by healthcare providers to allow visualization of the pharynx and larynx of a patient. The pharynx is the area directly behind the nose and mouth, and the larynx is better known as the voice box. A laryngoscope is specially designed to fit into a patient's airway to allow for a procedure known as orotracheal intubation, in which a tube is inserted via the mouth into the trachea, or wind pipe, to deliver oxygen and medication and to permit deep suctioning.
There
are two components to this instrument: the laryngoscope blade and the
handle. The handle contains the batteries needed for illumination and
the blade, which is inserted into the airway, has a bulb at the end of
it from which a bright light shines during use. These blades are not
sharp, and they do not cut the skin in any way. Laryngoscope blades come
in different sizes, with 0 being the smallest and 4 being the largest.
The size of the patient to be intubated determines the size of the blade
that the healthcare provider will use.
The handle and blade of the typical laryngoscope are two separate
pieces that have to be assembled before each use, but this can be
accomplished in a matter of seconds, allowing doctors and paramedics to
use this instrument in respiratory emergencies that require orotracheal
intubation. A laryngoscope is not a large instrument; the handle is
approximately the size of a door handle, and the blade is a little
shorter than the handle. There are two types of laryngoscope blades:
curved and straight. Both are inserted deep within a patient's airway.
A straight blade is used to lift a leaf-shaped structure called the epiglottis, which serves to prevent food and foreign matter from entering the windpipe,
and this type of blades generally is preferred when a pediatric patient
must be intubated. A curved blade is preferred when an adult patient
must be intubated. It is not the epiglottis that is lifted with a curved blade, which is inserted into another structure called the vallecula.
Regardless of the type of blade used, the goal is the same, which is to
allow visualization of the vocal cords through which the endotracheal
tube can be passed into the trachea. The importance of viewing the vocal
cords lies in the fact that it is vital that the doctor or paramedic performing orotracheal intubation ensures that he or she is placing the tube in the trachea and not the esophagus, the tube leading to the stomach.
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