Cite this post as:
Scott Weingart, MD FCCM. EMCrit 253 – Kovacs Kata to Optimize a Failing Laryngoscopy Attempt. EMCrit Blog. Published on August 9, 2019. Accessed on February 3rd 2023. Available at [https://emcrit.org/emcrit/kovacs-kata/ ].
Financial Disclosures:
Dr. Scott Weingart, Course Director, reports no relevant financial relationships with ineligible companies.
This episode’s speaker(s), (listed above), report no relevant financial relationships with ineligible companies.
CME Review
Original Release: August 9, 2019
Date of Most Recent Review: Jan 1, 2022
Termination Date: Jan 1, 2025
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All great and valid points. Although two handed laryngoscope operation seems a bit too much.
One thing I think is very important: if you don’t already know about this basic techniques, don’t know them by heart and don’t use them automatically, maybe you shouldnt be performing (advanced) airway management in the first place.
PS still using Miller blades for peds.
My 3 cts .
There is no upside for a mac 3 blade in anybody over 5 ft. Extra stick-out is ok within reason and a #3 and #4 are exactly the same height at the same length.
Your elbow should
always
be tucked in because of mechanical loop.
When it is that heavy, stop lifting with your arm, push with your legs. works best with the scope grabbed in the corner. Primary force will be axially on your forearm. It you can’t get it to move that way, do something different because something will break.
An addition at 10:00 on the video note that the patient is quite far away. Holding the head on the occiput ..I had a 195cm 160 kg patient with a buzzcut and a head the size of a planet and that doesn’t really work when you are that far away. If you move the patient all the way toward you, until you can can comfortably stand with the patients head against your body to keep the head in the position (flextention whatever it is now called). I tell residents to think how to fold the neck into a Z.. (Head… Read more »
Just out https://depthofanesthesia.com/optimal-position-for-viewing-the-glottic-opening/
Has a picture of what I meant.
Just out https://depthofanesthesia.com/optimal-position-for-viewing-the-glottic-opening/
Has a picture of what I meant.
it also has a review of litarature
Hi, i came across this reports. Had tried in on my patients, and i think they might be correct especially in reducing primary curve and soving hyperangulated problems. I hope you can elaborate or discuss more on this.
https://casereports.bmj.com/content/12/8/e230201
We have been discussing this article. here is my response: when i still used Millers the technique i used after having it beat into me by one of the anesthesiologists I most respected was to put the blade in the right corner of the mouth to cut the shortest path to the glottis and eliminate all interaction with tongue it seems they are using a similar strategy it strikes me as silly for a number of reasons, not the least of which is the ease with which anatomy can be missed and you wind up with the blade in the… Read more »
OR just call for an anesthesiologist 😉
A bunch of the Twitter links are broken. Just wanted to let you guys know. Thanks for the great work!