Blades and Handles
Jan 20, 2025🩺 Blades and Handles go to guide! 🩺
Laryngoscope blades and handles come in all different shapes and sizes – but how exactly do they differ? Here is your quick guide to the most common variations and their indications for use!
🔪 Blades:
👨⚕️ MAC (Macintosh) blades - most commonly used, attach to the handle at 90-degree angle. Follows the natural curvature of the airway, with the tip inserted into the vallecula to indirectly lift the epiglottis.
👩⚕️ Kessel blades - same curvature as the MAC blade, however it attaches to the handle at 110-degree angle (hyperangulated blade) to enhance airway visualisation in difficult airway situations. Often used in conjunction with a stubby handle in obstetric or obese patients.
👶 Miller blade - Straight blade with a slightly curved tip. More commonly used in paediatrics and adult patients with conditions that can cause anatomical differences such as Down’s Syndrome. These patients often have a more anterior airway, the Miller blade is beneficial in this scenario as it directly lifts the epiglottis (sits over the vallecula).
🚑 McCoy blade - Same curvature as a MAC blade, but the distal tip can be flexed by a lever to help displace the larynx forward. (Rarely used these days)
🔦 Handles:
🖤 Standard size handle - most commonly used, all variations of blades can be attached. 🏥
🖤 Stubby handle - much shorter than a standard handle, often used in conjunction with Kessel blade in obstetric or obese patients that may present with a short neck, barrel chest or large breasts. 🤰
🖤 Pen light/paediatric handle - thinner handle for smaller blade sizes. 💡
📉 Many of these blade types are used less frequently since the introduction of the videolaryngoscope in common practice, however it is still important to maintain knowledge of these blades and handles and their clinical indications in preparation for a scenario where the videolaryngoscope may fail or be unavailable. ⛑️
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References:
BESDATA (2024). Understanding Laryngoscope Blades: A Comprehensive Guide. https://besdatatech.com/laryngoscope-blades-guide/#types-of-laryngoscope-blades
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