King Vision Video Laryngoscope intubation with DuCanto

Thumbnail image for A Guide to Intubating through the Intubating Laryngeal Airway by James DuCanto

King Vision Video laryngoscope wielded by Master DuCanto

A short sharp video demonstrating the overhand technique and speed of intubation in a large patient with the King Vision video laryngoscope

Note how Jimmy does not even change the overhand grip and proceeds to pass the tube down the guide channel with his right hand. This takes some practice as most operators are used to inserting a laryngoscope blade like the familiar Macintosh with the “holding a beer can” grip position.

Also note the gas analyser display at the bottom of the screen showing inspired and expired O2 levels and the first reading appearing after intubation of an expired O2 of 94%, indicating adequate prexoygenation prior to intubation attempt.

Minh

6 thoughts on “King Vision Video Laryngoscope intubation with DuCanto”

  1. Hmmm..big patient.

    I like the KingVision, not least for the video out port which is used nicely here (capture using Elgato video to Mac or PC if you want to record)

    Couple of Qs:

    – overhand technique? What’s wrong with standard hold and just moving thumb from in-axis of laryngoscope blade across to the right to hold the ETT against the channelled blade?

    – I’ve been playing around this weekend with ProSeal and AirQII (CookGas) LMAs as conduit for ETT< using the KingVision (nonchannelled) blade to perform intubation via lMA under direct vision. Struggled a little , frankly, mostly with trying to get a decent view and not letting LMA cuff obscure KingVision camera…overcome by advancing the VL a little…but then the blade too close to the cords and bougie/ETT tend to dive below arytenoids to perform a beautiful video of oesophageal intubation!

    Any ideas on how to make this easier? I reckon an AmbuAscope or Levitan would obviate this, but is yet more $$$$ when the combo of KingVision and iLMA would seem to be robust and affordable for those 'tiger airways'\

    Thoughts?

    1. thanks TIm. Try deflating the LMA cuff a little as well as withdrawing it slightly to change the angle of exit of the bougie from the LMA bowl.
      Also a good amount of laryngeal manipulation partic posteriorly helps.
      Ideally get a Miller blade laryngoscope with a video camera tip..working on testing model of that which will plug via USB into a laptop…for less than $65..disposable

  2. 1. .Leave the Red tab on the Air-Q–It will automatically deflate to allow you to pass the blade past the heel of the cuff. It will also reinflate it to take up any gaps

    2. This overhand approach was an “experiment” that stems from my observation that overhand insertion of these hyper curved blades is easier in this approach. I decided to not re-grip the device prior to ETT advancement just to see if it was plausible. By golly, it is plausible, but a tiny bit awkward. This must be practiced on a mannequin first, of course. This overhand approach overcomes the awkwardness of King Vision blade insertion..

    3. Try intubating over the heel of an Air-Q placed in a mannequin using a Miller blade as Mihn suggests. It’s an interesting and easy exercise to to learn just what it is that you are trying to do.

    4. Forget the Ascope. Or go ahead and try it, what the heck. It’s good for a training lab, so you might as well get a monitor, training scope and a few disposables.

    I bought a monitor, 5 scopes and a trainer. I had one scope fail to work completely (125 USD gone into thin air), and one of my students broke my trainer scope. A Levitan can intubate 5 ways, but a flexible can intubate only one way (and only if it’s working).

    It does take time, effort, sweat, etc.. to learn the Levitan. But it can do just about anything, including cric and retrograde. I even placed a chest tube with it in a sheep.

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