Inexpensive video-laryngoscopy guided intubation using a personal computer: initial experience of a novel technique

Abstract

Video-laryngoscopy may provide an enhanced view of laryngeal structures compared to direct visualization. Commercial video-laryngoscopes are often expensive, limiting its adoption for routine use. We describe our initial experience using an inexpensive custom made device. Patients >15 years age, were randomly chosen, after informed consent, for video-laryngoscopy. A custom device easily assembled using an USB endoscopic camera, a conventional Macintosh laryngoscope blade size 3 or 4, and a personal computer was used. Patients with Mallampati class 1–3 were chosen. Video-laryngoscopy was recorded and reviewed. Twenty-four patients aged 16–68 years, of mean weight 58.46 ± 12.54 (40–86) kg were studied. The glottis could be visualized and intubation could be performed in all patients with 22/24 patients on first attempt. Mean duration of laryngoscopy was 22.17 ± 12.78 (7–59) s. Time taken for intubation, was mean of 28.58 ± 21.01 (9–89) s. Three patients with anticipated difficult airways could be intubated on the first attempt. Minor blood staining of the airway was seen in the video in two patients. Cormack–Lehane laryngoscopy grade visualized was 1 in 9/24, 2 in 15/24 patients. Percentage of glottic opening score was 62.29 ± 28.40 (20–100) %. Real-time video could be captured in all cases. The custom-made, inexpensive, video-laryngoscopy device is safe and reliable for clinical use. Real-time visualization and endotracheal intubation were successful in all patients, including those with anticipated difficult airway. Further, this device helps in archiving the video of intubation.