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14.4B) rather than act as a lever (see Fig. The laryngoscope should be used to lift (see Fig. The tongue and pharyngeal soft tissues are then lifted to expose the glottic opening. The blade is then advanced toward the midline until the epiglottis comes into view. The lips should not be pinched by the blade, and the teeth should be avoided. After propping the mouth open with a scissoring motion of the right thumb and index finger, the laryngoscope is inserted into the right side of the patient's mouth while sweeping the tongue to the left. The laryngoscope is held in the left hand near the junction between the handle and blade.Neck flexion may make it more difficult to open the mouth. On average, this improves the laryngoscopic view, although intubation and mouth opening may be facilitated in some patients by simple neck extension. The classic intubation position is the so-called sniffing position, with the occiput elevated by pads or folded blankets and the neck extended.Various modified laryngoscope blades provide better visualization of the cords through epiglottis lifting (Mc Coy) or indirect visualization of the cords (Siker and Trueview EVO).0 to 4, with most adults requiring a Miller no. The Miller blade provides excellent exposure of the glottic opening but provides a smaller passageway through the oropharynx and hypopharynx. The epiglottis is then lifted to expose the vocal cords. The Miller blade is straight, and it is passed so that the tip lies beneath the laryngeal surface of the epiglottis ( Fig.1 to 4, with most adults requiring a Macintosh no. It provides a good view of the oropharynx and hypopharynx, thus allowing more room for passage of the ETT with decreased epiglottic trauma. The Macintosh blade is curved, and the tip is inserted into the vallecula (the space between the base of the tongue and the pharyngeal surface of the epiglottis) ( Fig.The Macintosh and Miller blades are most commonly used. Intubation is usually performed with a laryngoscope. Intubation also may be required for specific surgical procedures (e.g., head/neck, intrathoracic, or intra-abdominal procedures). Endotracheal intubation is required to provide a patent airway when patients are at risk for aspiration, when airway maintenance by mask is difficult, and for prolonged controlled ventilation. Once the products are returned safely to our warehouse, We will refund you or replace the item as you wish.But We do our best to help you receive your order with any documentation you need. For NORTH AMERICA, RUSSIA, AFRICA and other Countries of ASIA, We`re not responsible for any custom problem in customer`s Country, No Refunds are eligible for Custom problems under any circumstances.For Customers from USA, CANADA, Europe, UK, MIDDLE EAST & AUSTRALIA we take responsibility to deliver your order without any custom issues or Duty problems.Any claim for incorrect shipment, faulty or damaged goods on delivery, must be made within 15 business days of receipt of goods.To return any product please visit our website here and fill out the form and submit.
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