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22-10: Video-Assisted Intubation—McGrath MAC EDL

Steven J. White; Kevin High; Lawrence B. Stack; Richard M. Levitan

The McGrath MAC enhanced direct laryngoscope is a combination direct and video laryngoscope in a compact, battery-powered device that uses disposable standard geometry curved Macintosh blades and has an adjustable LED screen (Figs. 22.54, 22.55, 22.56, 22.57). The King Vision, the iView, and the Storz C-MAC PM (pocket monitor) are additional versions of portable handheld video laryngoscopes currently available commercially.

FIGURE 22.54

McGrath MAC Enhanced Direct Laryngoscope. Compact video laryngoscope system shown here with a Mac 3 disposable blade. (Photo contributor: Lawrence B. Stack, MD.)

The McGrath M A C enhanced direct laryngoscope is comprised of a flexible display screen, a handle, and a curved, plastic Mac 3 blade.
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FIGURE 22.55

McGrath MAC EDL. Cord visualization using the McGrath MAC, which can also be used as a direct laryngoscope. (Photo contributor: Lawrence B. Stack, MD.)

A laryngoscopist inserts a McGrath M A C E D L into the open mouth of a supine mannequin, approaching from behind the head of the mannequin. The display screen shows the cord.
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FIGURE 22.56

McGrath MAC EDL. Vocal cord visualization and ETT delivery are demonstrated here. (Photo contributor: Lawrence B. Stack, MD.)

A laryngoscopist inserts a McGrath M A C E D L using the left hand, and inserts an E T T using the right hand, into the open mouth of a supine mannequin, approaching from behind the head of the mannequin. The display screen shows the vocal cord and the tube.
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FIGURE 22.57A

King Vision Video Laryngoscope. The King Vision laryngoscope is a disposable, battery-powered video laryngoscope with robust chip technology and a high blade angulation. (Photo contributor: Lawrence B. Stack, MD.)

The king vision video laryngoscope is comprised of a video display screen, a handle, and a blade with high angulation.
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FIGURE 22.57B

i-View Video Laryngoscope. The i-View is a single use, fully disposable video laryngoscope available in standard geometry Macintosh design. (Photo contributor: Lawrence B. Stack, MD.)

The i-View video laryngoscope is comprised of a video display screen, a handle, and a curved blade.
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FIGURE 22.57C

Storz C-MAC PM. The Storz C-MAC Pocket Monitor is a portable video laryngoscope that offers both disposable and nondisposable versions combined with high-contrast imaging and compact design. The device can be configured for both adult and pediatric use. (Photo contributor: Lawrence B. Stack, MD.)

The Storz C-M A C pocket monitor is comprised of a video display screen, a handle, and a curved blade.
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Technique

The disposable plastic Macintosh blade is placed onto the McGrath MAC EDL, and the device is powered on. The blade is inserted just to the right of midline of the tongue with the handle pointing toward the feet. As the tip of the blade advances downward along the tongue base and into vallecula, the tongue is swept slightly to the left to increase the amount of workspace. When fully inserted into the vallecula, the angle of the handle is now approximately 40 degrees from horizontal with lifting forces directed upward and forward. At any time, the laryngoscopist can switch from a standard direct laryngoscopy to a video laryngoscopy; however, once changed to video laryngoscopy, it is best not to switch back and forth from video to direct laryngoscopy.

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