A comparison between the Macintosh and the McCoy laryngoscope blades

Cook, T. M.; Tuckey, J.

doi:10.1111/j.1365-2044.1996.tb14971.x

Cited by 56 publications

(41 citation statements)

References 13 publications

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“…Our incidence of difficult laryngoscopy, defined as that with a laryngeal view of 3 to 4 according to Cormack and Lehane's classification [6], was 20% and this was higher than might be expected. Cook and Tuckey reported that visualisation of the larynx was better with the Macintosh blade than with the McCoy blade in the neutral position [2]. This may, at least partly, explain our findings, although with the McCoy blade elevated the view remained grade 3 or 4 in 10% of patients.…”

Section: Discussionmentioning

confidence: 46%

“…Although we appreciated the earlier findings [2], we wanted to compare the changes brought about by elevating the tip of the laryngoscope and modified cricoid pressure on the view obtained using the McCoy laryngoscope with the blade in the neutral position. In a study of 210 patients the incidence of difficult laryngoscopy was reduced when the McCoy blade was used in its optimum position, but the role of cricoid pressure in obtaining the best view was not evaluated [8].…”

Section: Discussionmentioning

confidence: 99%

“…However, there are conflicting reports about the view obtained when using the McCoy blade in the neutral position. One report indicates that the view is inferior compared with that obtained using a Macintosh blade [2] but another study, in which cricoid pressure was used, reported that the best view was never worse with the McCoy blade than with the Macintosh type [3]. Cricoid pressure backward, upward and to the right (BURP) has been reported to improve the laryngeal view during difficult laryngoscopy [4].…”

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confidence: 99%

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The best view at laryngoscopy using the McCoy laryngoscope with and without cricoid pressure

1998

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SummaryThe best view obtained by levering the tip of the McCoy laryngoscope blade with or without modified cricoid pressure was studied in 100 patients presenting for general surgery. The airway was assessed pre-operatively (Mallampati score, thyromental distance, mouth opening, protrusion of the jaw and weight) in an attempt to identify the patients who might benefit from the use of the McCoy laryngoscope. The vocal cords were visible at laryngoscopy with the blade in the neutral position in 32 cases. In the 68 remaining patients the vocal cords were partly visible in 48. The epiglottis only was seen in 18 patients and in two not even the epiglottis could be visualised. Elevation of the blade or modified cricoid pressure improved the view in 38/68 cases and 57/68 cases, respectively (p < 0.001, Wilcoxon signed rank). Using our method of pre-operative assessment we were unable to identify those patients who might benefit from either manipulation.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The best view at laryngoscopy using the McCoy laryngoscope with and without cricoid pressure

1998

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“…There is some question whether this is entirely valid, but the evidence suggests that if the McCoy laryngoscope (in the neutral position) performs less well than the Macintosh 3 blade, this affects grade 1 and 2 views and the magnitude of this effect is small [17]. We therefore included data from these papers.…”

Section: Methodsmentioning

confidence: 99%

A quantitative review and meta‐analysis of performance of non‐standard laryngoscopes and rigid fibreoptic intubation aids

Mihai¹,

Blair²,

Kay³

et al. 2008

Anaesthesia

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152

125

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SummaryThis quantitative review summarises studies of rigid fibreoptic laryngoscopy systems. In 6622 'normal' patients only the Bonfils and CTrach had homogenous data and first time intubation success rates above 90%. In 1110 patients predicted or known to be difficult to intubate only the Bonfils, CTrach and Glidescope had homogenous data and first-time success rates above 90%. In comparative studies with the Macintosh-3 blade, no device had homogenous data in more than one study. Many devices had higher summed performances, but due to data heterogeneity, interpretation is very difficult, if worthwhile at all. The currently available data do not provide strong evidence that these devices should supersede standard direct laryngoscopy for routine or difficult intubation. Further research needs to be of high quality, studying relevant patients to create such evidence. Multicentre collaborations are likely to be needed studying known difficult patients or creating databases reporting the success ⁄ failure rate of these devices.

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“…This finding is similar to that obtained with the routine use of the McCoy laryngoscope in adults, when in its inactivated position it does not appear to behave identically to the Macintosh blade. 8,9 Positioning the tip of the straight blade anterior to the epiglottis in infants may allow manipulation of the epiglottis with greater facility, but this needs further study. The curved size #2 blade for older children is available for use in such fashion.…”

Section: Objectifmentioning

confidence: 99%

The McCoy straight blade does not improve laryngoscopy and intubation in normal infants

Iohom

Franklin

Casey

et al. 2004

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : The McCoy curved blade laryngoscope has been demonstrated to improve view at laryngoscopy in adults. A straightbladed version of this laryngoscope has recently been introduced into pediatric practice. The objective of this prospective, randomized study was to compare the intubating conditions afforded by the McCoy (#1) straight blade laryngoscope with the conventional Miller (#1) blade in neonates and infants.

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A comparison between the Macintosh and the McCoy laryngoscope blades

Cited by 56 publications

References 13 publications

The best view at laryngoscopy using the McCoy laryngoscope with and without cricoid pressure

The best view at laryngoscopy using the McCoy laryngoscope with and without cricoid pressure

A quantitative review and meta‐analysis of performance of non‐standard laryngoscopes and rigid fibreoptic intubation aids

The McCoy straight blade does not improve laryngoscopy and intubation in normal infants

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