Neonatal laryngoscopy and endotracheal tube advancement
THE CONTEXT
The procedure uses tongue-base and glottic landmarks to guide blade placement and endotracheal tube insertion.
Blade placement and visualization
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Hold the laryngoscope between the thumb and first three fingers, with the blade pointing away from the operator.
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Stand at the infant's head end, introduce the blade into the mouth, and advance it just beyond the tongue base until its tip rests in the vallecula.
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Lift the blade and identify the epiglottis and glottis. The vocal cords surround the glottic opening on either side.
Tube advancement
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Once the glottis is visible, introduce the endotracheal tube from the right side of the mouth.
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Advance its tip into the glottis until the vocal cord guide is at glottic level. This positions the tube tip halfway between the vocal cords and carina.