- What Is
What are video laryngoscopy and fiberoptic-assisted tracheal intubation?
Tracheal intubation, also called intubation, involves placing a flexible plastic tube (endotracheal [ET] tube) into the trachea (windpipe) to maintain an open airway, ventilate the lungs, or administer certain drugs. Video laryngoscopy and fiberoptic laryngoscope aid in tracheal intubation.
Video laryngoscopy is a form of indirect laryngoscopy in which the physician does not directly inspect the larynx. Instead, the larynx is visualized with a fiberoptic or digital laryngoscope (a camera with a light source) inserted transnasally (through the nose) or transorally (through the mouth).
Images and videos captured during video laryngoscopy can be displayed on a monitor for clinicians, patients, and others to view at the time of the procedure. It can also be recorded so it can be viewed at a later time. The images and video also help monitor disease progression and treatment. The images are magnified when displayed on the monitor, which helps in the detailed examination of the larynx. Video laryngoscopy forms the basis of fiberoptic intubation.
Fiberoptic intubation involves inserting an ET tube over the shaft of a flexible fiberoptic scope for visualization. Video laryngoscopy is also used with rigid transoral laryngoscopy. There are various variations to a rigid laryngoscope. The rigid laryngoscope can also be connected to a camera and monitor.
When is video laryngoscopy and fiberoptic-assisted tracheal intubation done?
Tracheal intubation is indicated as a medical procedure in various medical conditions that prevent a person from maintaining a clear airway, breathing, and oxygenating the blood. It is indicated in the following conditions:
- Inability to maintain an open airway
- Inability to protect the airway against aspiration
- Failure to ventilate
- Failure to oxygenate
- Lung and cardiac failure
- Provide general anesthesia, maintain the airway, and provide ventilation during surgery
Indication for fiberoptic-assisted tracheal intubation:
- Any patient who meets the criteria for intubation can be intubated fiberoptically. However, because of equipment involved, most doctors use fiberoptic intubation for patients who have a difficult airway.
Patients with the following conditions or in the following categories are likely to have a difficult airway:
- Micrognathia (much smaller or shorter lower jaw than the rest of the face)
- Mandibular (jaw) fracture
- Partially obstructing laryngeal lesions such as tumors
- Cervical (neck) spine injuries or cervical instability
- Rheumatoid arthritis or patients who are unable to extend the neck due to other conditions
- A history of head and neck radiation therapy
- Trismus (lockjaw)
- Craniofacial abnormalities (birth defects of the face and head)
When is fiberoptic-assisted tracheal intubation not done?
Fiberoptic intubation is contraindicated in patients
How are video laryngoscopy and fiberoptic-assisted tracheal intubation performed?
The procedure can be performed with the patient either awake or sedated.
If the patient has a difficult airway, the procedure may be performed when they are awake using fiberoptic-assisted intubation. This is called awake intubation.
In some circumstances, if the patient is anxious and unable to tolerate the procedure, they may be given mild intravenous sedation. For the awake patient, the procedure may be done with the patient seated or lying down, and local anesthesia would be provided to the nose and throat.
- Nasal intubation with general anesthesia: The technique of intubating nasally with the patient under general anesthesia is similar to that of awake intubation. After general anesthesia is induced, the patient is mask-ventilated in the supine position.
- Oral intubation with sedation: Oral intubation is usually performed with the patient sedated. The patient may also be sedated and kept spontaneously breathing. An oral airway often makes this easier and lifts the tongue off the posterior pharyngeal wall, facilitating exposure of the larynx. In oral intubation, the tongue can be grasped and lifted, providing better exposure, and hence, it is preferred.
- Rigid video laryngoscopy: Several rigid laryngoscopes may be used for video laryngoscopy. The laryngoscope is attached to a camera and light source. Rigid laryngoscopy is usually performed under sedation.
What are the complications of video laryngoscopy and fiberoptic-assisted tracheal intubation?
- Equipment malfunction
- Trauma to the structures in the throat, vocal cords, trachea, or esophagus (food pipe)
- Spasm of the larynx
- Huge Mass of Sargassum Seaweed Is Targeting Florida's Coast, With Hazards to Health
- ER-Based Pharmacies Could Improve Kids' Care, Pediatricians' Group Says
- With Training, Soccer Headers Might Be Safe for Teen Players
- Compounds in Chocolate, Berries Might Help Boost Memory As You Age
- Stress Across the Life Span Could Worsen MS
- More Health News »
Health Solutions From Our Sponsors
Medscape Medical Reference
Top Video Laryngoscopy Fiberoptic Tracheal Intubation Related Articles
Respiratory Illnesses: 13 Types of Lung InfectionsIs your cough caused by a cold, flu, pneumonia or something else? Learn causes of respiratory infection like bronchitis, pneumonia, SARS, Coronavirus COVID-19 bird flu, and more.
Congestive Heart Failure (CHF): Symptoms, Causes, Stages, TreatmentCongestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
COPD Lung SymptomsCOPD is a pulmonary disorder caused by obstructions in the airways of the lungs leading to breathing problems. Learn about COPD symptoms, diagnosis, and treatment options.
What Are the Different Types of Mechanical Ventilation?Mechanical ventilation is a treatment to help a person breathe when they find it difficult or are unable to breathe on their own. A mechanical ventilator pushes airflow into the patient’s lungs. Mechanical ventilation is part of the arsenal of supportive care clinicians use for COVID-19 coronavirus disease patients with the most severe lung symptoms.
What Is Endotracheal Intubation?Doctors perform endotracheal intubation when a patient cannot breathe on their own, whether it is due to surgery, disease, or an emergency. Endotracheal intubation is the safest way of providing breathing support to COVID-19 coronavirus disease patients who have severe lung symptoms.
First Aid: Why You Need a First Aid Kit and CPRFirst aid is providing medical assistance to someone a sick or injured person. The type of first aid depends on their condition. Preparedness is key to first aid, like having basic medical emergency kits in your home, car, boat, or RV. Many minor injuries may require first aid, including cuts, puncture wounds, sprains, strains, and nosebleeds. Examples of more critical first aid emergencies include heart attacks, strokes, seizures, and heatstroke.
Heart Failure: Causes, Signs, Stages, and TreatmentHeart failure (congestive) is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats. There are two types of congestive heart failure, systolic or left-sided heart failure; and diastolic or right-sided heart failure. Treatment, prognosis, and life-expectancy for a person with congestive heart failure depends upon the stage of the disease.
Heart Failure QuizWhat is heart failure? Learn about this dangerous condition, as well as who is at risk, and what to do about it.
Reasons You're Short of BreathHave you ever found yourself gasping for air after just a short flight of stairs? You may just need to do a bit more exercise, or it could be something more serious.
Lungs PictureThe lungs are a pair of spongy, air-filled organs located on either side of the chest (thorax). See a picture of the Lungs and learn more about the health topic.
Surprising Causes of Lung DamageCarpets, fireworks, and hot tubs are some of the unexpected things that can hurt your lungs. Find out what you can do to prevent problems from these and other culprits.
What Are the 4 Stages of Congestive Heart Failure?The New York Heart Association developed the four stages of congestive heart failure depending on the functional capabilities of the heart which includes Class I, Class II, Class III, and Class IV.
What Are the Types of Noninvasive Ventilation?A ventilator is a machine that helps in delivering oxygen to your lungs. It is used to assist with breathing when you cannot breathe on your own. There are two types of ventilation includes invasive ventilation and noninvasive ventilation.
What Causes Congestive Heart Failure?Congestive heart failure is a chronic disease that progresses with time if left untreated. Heart failure can occur due to diseases of the heart, the blood vessels supplying oxygen and nutrients to the heart, or sometimes from factors outside the heart (extracardiac causes). With proper management, people who have congestive heart failure can lead nearly normal lives, depending on the severity of the condition.
What Drugs Are Used in Rapid Sequence Intubation?Rapid sequence intubation (RSI) is the administration of a strong anesthetic agent followed by a rapidly acting paralytic agent (all within one minute) to make the patient unconscious. Drugs used in rapid sequence intubation (RSI) include potent anesthetic agents (propofol, ketamine, etc.), muscle relaxants or paralytic agents, and pharmacological adjuncts (fentanyl, lidocaine, etc.).
What Is Bag Valve Mask Ventilation (BVM) Used For?Bag-valve-mask (BVM) or the Ambu bag is a self-inflating bag used to provide ventilation to the person not breathing normally. BVM ventilation is a critical skill for emergency providers. BVM ventilation is a technique that restores breathing in patients who are not spontaneously breathing. BVM ventilation is indicated in the respiratory (lung) failure, failed intubation (insertion of an artificial ventilation tube into the trachea), patients undergoing anesthesia for elective surgery, and apnea (slowed or stopped breathing).