Chapter 15 - Tracheal intubation: rigid indirect laryngoscopy

Summary

Rigid indirect laryngoscopy (RIL) can overcome some of the problems inherent to direct laryngoscopy and intubation using a flexible bronchoscope, but it has its own drawbacks. There is no ideal intubation device. This chapter discusses the design and technical features of rigid indirect laryngoscopes. No classification of equipment has yet been generally accepted, and a simple scheme is discussed: optical stylets, bladed indirect laryngoscopes, and tube-guiding indirect laryngoscopes. RILs allow visually controlled TT placement and visual confirmation of the tube passing between the vocal cords. RILs eliminate the need to align the axes of the upper airway and in general require less force to achieve a good view of the laryngeal inlet compared to DL. The built-in optics and electronics usually allow viewing of the image by multiple spectators and also allow documentation of successful intubation. The market for RILs is fast-moving.