Thanks for the replies...
Try improving your positioning. True sniffing position (10 cm elevation of the occiput) will really improve you views. Don't let people compromise that position with pillows, placing the head flat, etc.
WntrMute, your point about position is an excellent one. Agree completely. At this particular clinical site, a couple of the preceptors want me to do things their way, i.e. use a pillow for positioning, don't use a foam headrest, no ramping with blankets, Miller vs MAC, etc. Sometimes, it's just easier to go with the flow at clinical - you know what I mean.
first of all there is no relationship between ASA status and airway grade of view!!!! I have had ASA I pts that were can't ventilated/can't intubate (very bad!)
Dang, Tenesma, you must think I am a real dumbs&*t. Allow me to clarify. My correlation with missing intubations and ASA levels has nothing to do with airway class and everything to do with cardiorespiratory reserve. I am not going to subject an old COPDer or s/p CABG patient who can't even walk to his mailbox (how many mets is that?!) to protracted or multiply-repeated laryngoscopy. If I can't see what I need to see in short order with repositioning, cricoid pressure, or tracheal manipulation, then I am out of there and my preceptor can give it a go.
Hi D, how are things?! Liked your article in the newsletter! I'm thinking part of it might be that I am a MAC lover trying to use the Miller more often. One of my preceptors noted that if the Miller 3 is the blade you would pick in a difficult airway scenario, why not use it all the time? Interesting point. My goal is to try to get proficient with whatever blade is in the box, keep their teeth absolutely untouched, and not nick lips. What do you mean by "fishing"?