Intubation technique question

ICUDOUCME? · Mar 16, 2008

I have been told to go in on the right and sweep the tongue to the

left in order to get it out of the way. Some people's tongues are big enough that you would have a hard time just going straight in and pulling up to get it out of the way.

The Mac is a good blade and I like to use it for pts with redundant tissue in the neck. The miller is good for me because I like being able to directly get the epiglottis up and out of the way. I am, in no way, an expert and I struggle a lot with both blades. I'm getting better and I have confidence that I will continue to improve the more I do. So you are not the only student who feels like you do.

One thing, you will have every preceptor tell you different things and they are all correct. So just do it the way they tell you and try to see how their way is correct. Once you are on your own more, you can gravitate to the one way that makes most sense to you.

CrufflerJJ, BSN, RN, EMT-P · Mar 16, 2008

I am a student Nurse anesthetist and have been in my clinical rotations for a few months 1-2 times a week. I am still having a hard time with the intubating process. I always use the MAC blade as it is the only one I have had success with. My question is when you put the blade in the mouth is it ok to go straight in or do you have to have the blade turned and off to the far right side and sweep the tongue before going in. I am being told two different ways. I find it easier to just go straight in midline to the back of the throat and once in lift and look for the epiglottis, however I was told this is not correct. What are your thoughts?

You might consider practicing with a Miller (straight) blade on an intubation dummy, if you've got one available. That way, you can play around with cric pressure, depth of blade insertion, different blade lengths, head/neck positioning...

Ideally, you'll want to get as comfortable with the Miller blade as your Mac blade. Depending on the pt, you might need to choose between Miller & Mac blades. Most folks I tube (as a Paramedic) with a Miller, but sometimes use the Mac if neck extension is a no-no.

To answer your question, though, I've always swept the tongue to the left with the Mac blade - I think that's what the "vertical" blade extension on the side of the Mac blade is for anyway.