

Glottic opening at level of C1 in infants.Preemie may need shoulder roll to get ear to sternal notch aligned.ETT Size: (Age/4) + 4 for uncuffed, (Age/4) + 3.5 for cuffed.Therefore a total of 50 children will be enrolled.Pediatric Airway Equipment Sizes Los Angeles Airway Card Age To account for photographic difficulties, unreadable photos as well as dropouts, we will enroll 25 children in each group. In order for to detect superiority of one technique over the other, we will need a difference in the POGO scores of 25 points with a standard deviation of 25 points, yielding a sample size of 15 children in each group. However, views will be obtained with the Miller and Macintosh blades both lifting and not lifting the epiglottis and comparisons between pairs of measurements will be performed. The primary hypothesis of this study is to compare the view of the larynx with Miller blade while lifting the epiglottis to the Macintosh blade lifting the tongue, in infants and children <2 years of age. There will be no payments or compensation to the study subjects.Lerman (Room 251) in Department of Anesthesia, Women and Children's Hospital of Buffalo during and after the study for security to protect subject privacy and confidentiality. The research data will be stored in a locked office of Dr.No patient identifiers will be included on any documentation apart from the source documents.They will be stored in a secure file once the study is completed that will be accessed only by investigators involved in the study. The images obtained will not have patient identifiers included.Yuvesh Passi, Jerrold Lerman or Chris Heard. All of the intubations and image acquisition will be performed by Drs.Photos of the glottic opening will be graded using the POGO scale (Ref1) by a third (blinded) anesthesiologist.The two views will be recorded by a second doctor using a SONY camera at the mouth adjacent to the laryngoscope handle.This difference is a matter of moving the position of the blade back without removing the blade from the larynx. During the same laryngoscopy, the best glottic visualization will be obtained with the blade lifting the epiglottis and not lifting the epiglottis, in random order (by flipping a coin).The child's head will be positioned in the Magill position, muscle relaxant will be administered, firm forward traction will be applied to the laryngoscope handle, and if needed, external laryngeal manipulation will be applied. The best possible glottic view will be obtained by ensuring the following steps.
#Mac blade sizes code#
At that time, the randomized code for that child will be opened and laryngoscopy will be performed with either a Miller or MacIntosh blade as indicated by the code. The lungs will be mask ventilated using 100% oxygen in Sevoflurane for 3 minutes to allow appropriate time for the muscle relaxant to be fully effective. The child will then receive a standard intubating dose of a muscle relaxant (rocuronium 0.5-1 mg/kg). An intravenous cannula will then be placed. After obtaining informed consent from the parent or the legal guardian, monitors (electrocardiogram, non-invasive blood pressure monitor and pulse oximeter) that are routine induction of anesthesia will be applied and anesthesia will be induced using an inhalation technique with sevoflurane, nitrous oxide and oxygen.They will be randomized to one of the two groups: a #1 Miller or Macintosh blade.After Institutional Review Board approval, the patients meeting inclusion criteria will be selected from the Operating room elective surgical list.Why Should I Register and Submit Results?.
