MAC 3 or 4? What do you use and why?
What laryngoscope blade do you commonly use in your intubations? I have been having an email discussion with a couple of anaesthetists about this over the past week. The feature image shows two of my personal laryngoscopes I currently use. My favourite is the disposable Trulite MAC 4 bladed LED laryngoscope pictured. Note the LED light is much brighter than the second laryngoscope, despite being AA alkaline battery powered. The smaller MAC 3 bladed laryngoscope has a German low profile steel reuseable blade with an acrylic light bundle. The handle is a micro length design using CR 25 lithium batteries common to cameras and a standard bulb. The lithium battery produces a higher intensity light but that still does not equal the LED from the Trulite.
Trulite costs $12 ea in all the common blade sizes inc straight blades. The German Profile blade is about $70 ea and micro handle about $25 ea.
Dr Levitan recommended me first off the German profile MAC blade and micro handle and it works well but for 2 years now I discovered the Trulites after he showed one to me at a workshop he did for us. I have been using them ever since and they just work well in my prehospital setting.
Anyway MAC 3 or 4? does it matter? I think it does. I prefer MAC 4 first pass, use a careful midline approach and steadily acquire anatomical landmarks, searching for the epiglottis. If I need the length, its there already. If I dont then I end up using maybe only half of the blade but I am used to that now. My colleagues argue MAC 3 straight up as it works for most adults and gives you best mechanical advantage of tip into vallecula.
What do you use and why?