Soft-tip intubating stylet

Abstract

Endotracheal intubation using a laryngoscope is the most rapid and usually the easiest means to ensure a patent airway. It has therefore earned its popularity in anesthesia and other acute health care practices. However, intubation by conventional technique is not always successful as at times direct vision of the glottis/vocal cords is impossible during laryngoscopy. Thus, acute airway obstruction remains a constant problem in all acute health care practices. To deal with this challenge, we have developed a new technique incorporating a modified Satin-Slip intubating stylet (Mallinckrodt Medical, St. Louis, MO, USA). First, cut the plastic sheath of the stylet at its distal end and push the sheath forward about one and a half inches. The soft plastic tip of the malleable stylet is then allowed to protrude from the endotracheal tube (ETT). When visualization of the glottic aperture is not possible, one simply places the soft plastic tip of the stylet under the epiglottis and advances it forward, and the tip will eventually enter the larynx. The ETT is then advanced off the stylet into the trachea. This new technique works very well in our experiences. It can be performed quickly with readily available inexpensive equipment. Our favorable experience leads us to believe it is one of the most promising additions to the current recommended alternatives.