Emergency Medicine –
The blade was definitely designed with the Emergency Physician in mind. Intubations here require fast judgement, fast action, and failure is not an option.
As an Emergency Physician, I always felt the Miller and McIntosh Laryngoscope Blades were difficult to use, and that improvement was long overdue. I brought together the best of both blades. It is 80% wider, and the curvature conforms to the airway much better. It is designed to go over the tongue, therefore, you don’t have to worry about a large or floppy tongue.
It is currently being used in Emergency Departments throughout the country. Many ER docs carry one with them at all times, to be sure they are never without it in the ED and when called to the floor.
I personally have never had a failed intubation using the Grandview Blade. Even though I have learned how to use the newer video devices, I have never had to use on a patient. I often was called to the floor because they knew my success rate with the GV Blade was so good. I have heard the same thing with other ED physicians.
A controlled study was performed by the Midwestern University (Chicago Osteopathic) EM Residency program and demonstrated that the Grandview Blade is superior to the Miller or McIntosh Blades. (see the reference section).
Video devices seem to be popular at this time. However, the Grandview blade gives a great wide open view without having to set up or rely on a video screen. With the GV blade, you seldom need the video.
The Grandview blade should be used as initial attempt, then on the rare occasion you are unsuccessful, the video device will be ready by then.
The Grandview Blade is available in a Pediatric version (similar to a Mac2) and an adult disposable version. It also a fits on standard handles. And its patented brighter light rivals the fiberoptic versions.
As in any new instrument or
technology, it is important to learn the proper technique. Most MD/DOs would think the technique is the same. However, we have found that it works best if you follow a slightly different
technique than with the Miller or Mac. It works best if you don't do a "Right side and sweep"; but to go straight over the tongue. This is what prevents the tongue from obstructing
the airway, eliminating the effects of a large floppy tongue.
See my YouTube Video to see my instructional video.
Also, you might also look at another YouTube Video with the AirwayCam that demonstrates the use of the Grandview blade with a cadaver. The wide open view is self explanatory:
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Grandview Intubation Blade
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