Rigid endoscopes are very valuable tools for intubation in certain difficult scenarios, but are not commonly used in most centres. The techniques and learning curve differ significantly from normal direct laryngoscopy, requiring independent practice to become proficient. Pictured here are (left to right) a rigid bronchoscope, Bonfils, Levitan and Shikani optical stylets (rigid intubating endoscopes).
This is the set-up for basic training on an UCT Anaesthesia Airways course. Which of these devices have you used? Do you have tricks or comments to share?
Intubation in a young child with a severe submandibular abscess using the paediatric Bonfils rigid intubating endoscope under inhalational general anaesthesia. Direct laryngoscopy showed only severe swelling with a Cormack-Lehane grade 3b view. A standard laryngoscope was used with the left hand to create an open path for the Bonfils just right of the midline, avoiding the worst of the submandibular swelling. 3.5mm Bonfils allowed intubation with a 4.5 mm uncuffed ETT. Note that because this is a rigid intubating scope, it is not inserted through the vocal cords, but they are visible through the tube as it is inserted with the Bonfils held steady.
Open access meducation for all aspects of airway management