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ANESTHESIA AND ANALGESIA . . Current Researches VOL.54, No. 3, ILIAY-JuNE,1975

BRIEF REPORTS EDWIN S. MUNSON

ASSOCIATE EDITOR...

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An Indirect-Direct La ry ngoscope JOHN

P. HUFFMAN, C.R.N.A.*

T

HIS report describes a modification of the prism laryngoscope described several years ag0.l The design of the plastic blade allows more space for examination of the larynx and passage of the endotracheal tube (figure). The indirect-direct laryngoscope? is constructed to allow the conventional direct method of exposure, while the lower prism, which occupies the space where the Macintosh flange is situated on the metal blades, permits indirect viewing of the glottis. The viewing prism allows a 30" refraction in the direction of the larynx and a 20" refraction to the left of midline view. The latter permits an indirect view of what is also seen in the conventional direct line of exposure.

Use of the viewing prism is optional. It is frequently helpful for difficult examinations of the larynx. Applying soap over the distal end of the viewing prism prior to use helps prevent fogging. The soap is wiped off the prism just before use. At times, during difficult laryngeal exposure, forward leverage On curved and straight metal blades inadvertently pushes the larynx from view, requiring the operator

?Concept Inc., Clearwater, Florida.

FIGURE. The Indirect-Direct, 130mm. laryngoscope and solid-state pocket light.

indirect prism is used.

*Product Development, Concept Inc., Chicago, Illinois 60657. Paper received: 10/3/74 Accepted for publication: 12/17/74

405

Brief Reports

High-intensity illumination, provided by a solid-state pocket light (Maxi-Lite) and acrylic light pipe, permits adequate illumination of the airway and larynx. The art of endotracheal intubation depends on the knowledge and Skill of the individual; this instrument, which effectively

aids difficult laryngeal exposure, may be helpful in improving such skill.

REFERENCE 1. HutEman Jp, Elam Jo: Prisms fiber optics for laryngoscopy. Anesth & b a l g mM-67, 1971

Foot-Pedal Control of Jet Ventilation During Bronchoscopv and Microlaryngeal Surgery EDWARD CARDEN, M.A., M.B., B.Chir., FRCP(C) JUAN GALIDO, M.D. Los Angeles, California*

designed a foot-pedal system which enables the anesthesiologist to control jet ventilation during bronchoscopy or microlaryngeal surgery. Cast-aluminum foot-pedal switches, in two sizes, can be obtained from the manufacturer? at a cost of less than $25. Each device (D, E, fig. 1) weighs 300 gm., measures approximately 11 x 4.5 cm., and has holes for mounting onto an appropriate base or fastening onto a specially-designed safety guard (fig. 2 ) . Three gas connections on the switch, are so arranged as to permit continuous gas flow only when the pedal is depressed or only when the pedal is released. We compared the flow characteristics of this foot valve with three commonly-used hand-operated blowgun valves (fig. 1): the Sears blowgun, the Acme air blowgun, and the Whitey blowgun. Each device was powered by a 50-psi oxygen source and connected by a 30-inch length of rubber tubing (3/16 inch I.D.), to a 200 L. Collins spirometer. The volume of gas delivered to the spirometer from each valve was measured for a 30-second period on three occasions to determine the average flow rate of each system. The 62 L’/min’’ FIG.1. Types of foot switches and hand-operated the Sears valve 172 L./min., the Acme air blowgun valves tested: A. Acme air blowgun. B. valve 173 L./min., and the ARO valve 224 Sears, Roebuck blowgun. C. Whitey blowgun. D. L./min. The resistance to gas flow through ARO Type 547 (large pedal) foot valve without E HAVE

~

?The ARO Corporation, Bryan, Ohio.

connectors. E. ARO Type 547 (small pedal) foot valve with fitted connectors.

*Department of Anesthesiology, UCLA School of Medicine, Los Angeles, California 90024. Faper received: 10/7/74 Accepted for publication: 12/30/74

An indirect-direct laryngoscope.

404 . ANESTHESIA AND ANALGESIA . . Current Researches VOL.54, No. 3, ILIAY-JuNE,1975 BRIEF REPORTS EDWIN S. MUNSON ASSOCIATE EDITOR... . An Indi...
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