Lesson 5 - Direct Laryngoscopy: MICU Fellows Airway Course

At last, we arrived! All of the preceding chapters served as necessary to this -- the thing we usually think of when we mention an airway course. This is the way we put the tube in most of the time, after all.
Preparation is everything -- get the patient in a good position, the sniffing position, to align all the different axes so you get the "straightest possible shot" into the trachea.
Now that you have them lined up, induce with those agents/relaxants that work out best for this particular patient. Mask (unless this is a rapid sequence induction), scissors the mouth open, place the larygoscope blade far to the right (to the right of the tongue), go deep into the mouth, then pull back until the epiglottis falls down into view. Then lift along the direction of the handle, that will keep you pulling away from the teeth and avoiding damage. Once you see the cords, gently place that endotracheal tube through the cords.

[fionnaigot]

"I would rather swallow my pride than hurt a patient."

wise words sir☺️☺️

[rafrafiki]

I wish this Doctor would be my teacher. I like the way he explains things more easily than more professors. And he looks more friendly.

[fw]

'it's okay to ask for help'
'bougie is not a sign of weakness'

Thank you Dr for your guidance.

[Angell_Lee]

"Change something, don't reinforce failure." - Dr. Gallagher. Wow what a great quote and applicable in every aspect of life!

[joeh]

I'm a paramedic student and prior military medic. I wish I had you as an instructor during my airway lectures and labs, especially before a deployment. Well done Doc!!

[sohelsaheen]

It is the one video that each and everybody should watch again and again. It is not only for the clinicians but also very much fundamenta matter for the health care/volunters . THANKS for this video.

[william]

Love it! I’ve been a physician for 19 years trauma surgery and the past 7 years a PHP as well! Awesome explanation, but for reference... 90% of the time I personally do not use a stylet. I will also reinforce your statement never be too proud to ask for help.... if you are too proud to ask you’ll never make it as a good physician! ALL medicine is team work end of story!

[Anilkumar-fbkw]

Sir, more than 21 years in icu.And intubated more than 6000 patients (in icu, in casualty, in ccu, in post op icu, in dialysis unit, in an ambulance, even road side -sometimes as emergency. God lives in a ventilator, so intubation and connecting to it is always like worshiping God. Each one appears seperate even after thousands. No other procedure gave me such a satisfaction. Thank God

[dr.aditirana]

I’m a new intern doctor in India, I was having trouble with intubation thanks for this 🙏 it was really helpful 😊

[adriando]

Thank you so much sir for making my life waaay easier.
I’m a med student and a fan of you now!! I appreciate that you put a free lecture video here with the most conscientious instructions I’ve ever seen.

[eveninglaisa]

I just had this procedure done where they put a special balloon in my esophagus to stretch it wide so I can breathe better.
I was wrongly diagnosed with asthma for 3 yrs taking all those inhaler’s and prednisone.
Thank GOD it didn’t damage my Liver.

[mlshometours]

It sure would have been nice to have this doc as a teacher when I was in training. He explains everything so well and simplifies and reviews the steps for success. Definitely will follow him

[prakashchrist]

you r a good doctor to your patients...and you are a good teacher to us...i am icu staff from tamil nadu...

[geoindian]

Good morning Sir, Thank you for the wonderful video, apart from technique, a lot of wisdom and inspiration.I am watching it today, 7 years after you have posted , as I am getting ready to face the covid pandemic. Thanks again.

[pricillafrinka]

successful intubating a patient on the first attempt today using all of your tips. glad i watched it over and over. thank you, please keep sharing doc🙏🏻

[naggar]

I have had multiple times when I started getting the hang of intubating quickly where patients crash immediately after and resuscitation fails. Asked multiple consultants and none of them could give me an answer as to why. Here I have finally reached that answer. Thank you very much

[lenz]

You explained everything clearly, taking into account all possible classic mistakes and even patient's other medical conditions. Very thorough instructions. Thanks!

[arlettealfonzo]

I’m on my first year program as RT and I really find your videos amazing!

[l.bailey]

Great teacher... I'm going to tell you the prideful measure he spoke about is a must.! Part of loving your patience is being able to ask another co-worker to step in just saying.

[kellymoran]

I've been a Firefighter/Paramedic for 25 years and went to Paramedic school in 1995. We learned endotracheal intubation on mannequins and even did our cardiac and trauma megacodes on them. We then went and spent 2 full weeks in the O.R. under an Anesthesiologist tubing patients the entire time. We had to have a minimum of 25 adult successful and 5 pediatric intubations. We graduated and ive intubated my fair share of easy as well as difficult airways. Remember another technique for anterior anatomy..cricoid pressure and I totally agree if you don't get them intubated.. Pass it off to your partner. Very nice video, Doc..great refresher course.