Novel Use of Glidescope Indirect Laryngoscopy for Insertion of a Minnesota Tube for Variceal Bleeding

Adam B. Schlichting, MD, MPH; Jayna M. Gardner-Gray, MD; Gina Hurst, MD


J Emerg Med. 2015;49(1):40-42. 

In This Article

Novel Use of Indirect Laryngoscopy

In order to aid in the placement of these devices, we employed the use of a video laryngoscope for indirect visualization of the esophageal tamponade catheter being passed into the esophagus and have successfully utilized this technique in 4 patients. Use of direct laryngoscopy for assistance with esophageal tamponade balloon placement has been utilized previously. However, indirect laryngoscopy offers the advantage of a video display for multiple viewers to observe the placement of the catheter into the esophagus. Additionally, it allows the operator to be positioned farther from the source of the hematemesis, thereby reducing likelihood of blood and bodily fluid exposure. Potential limitations to use of indirect videolaryngoscopy for insertion of a Minnesota tube include the need for additional equipment and occlusion of the camera by blood. We feel, however, that most EDs already have access to a videolaryngoscope, and having two suction devices available during insertion as well as use of pharmacologic paralysis should help prevent occlusion of the camera by blood.