Mac 3 vs Mac 4: the mechanical disadvantage of a longer blade
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- Опубліковано 18 лют 2013
- Demonstration of the impact of increased laryngoscope blade length on ability to lift the tissues at the tip of the blade. This produces a significant advantage of the Mac 3 in getting an optimal view of the larynx where it is long enough for the blade tip to be placed correctly in the vallecula fossa. Choosing the shortest blade that is long enough will give you your best attempt.
Great point, thanks for the video. I teach the same to my residents!
Totally agree. I usually have problems intubating using size 4.
good stuff, thanks
Point noted, Thanks!!
Thanks man!
I think it is technique that helps more while intubating difficult airway like corman lehan 3
My question is, what is an objective way to determine the correct blade length, mac 3 vs mac 4, other than attempting intubation and realizing it is too short? just a guess but, measure from lip to hyoid? any research or suggestions?
MAC 3.5 ftw!
Jimthemedic truth has been spoken 🤣🤣
Love the 3.5
what about a Windows 3 or a Windows 4?
Thats why there are different size blades for different size patients..
Hi, I thought this video was interesting but you don't need a lot of force to lift, considerably less you you could apply; i think not changing blades and having a reduction in the volume of laryngoscope in the mouth both outweigh the benefit you suggest. Small movements at a pivot point with increased distance to the tip of your blade will increase the vertical distance moved by that tissue - which is important when attempting direct visualisation of the laryngeal inlet.
Choosing the blade that will limit time instrumenting the supraglottis I agree is the most important. Always using a 3 blade or a four blade is crazy ay.
i always use a mac 4 blade. I also put my fingers way nearer to the angle so there is not much strenght needed
Thank you for Anesthesia.🌞👍
😎✌🏻
In my experience, about 40 years, 4 blade is better. When a colleague has a problem with 3 blade I can resolve with 4...
Easier to use a shorter blade . You have more control !
Use Miller
Or just a Miller blade and not have this problem 🤷♂️
Please don't get fixed on any such ideas....if one thing is not working well for you, try the other. And for most men Mac-3 is too short and no point in lecturing the mechanics involved.
I disagree. *most* men can be intubated with a mac 3 blade providing your positioning is good and laryngoscopy technique is well practiced. It is only if the men are huge that a mac 4 is required
Wrong.
This argument is flawed as it is Darwinian. Wedging the blade is totally different to lifting the blade. Using proper laryngoscope techniques is the answer. 4 blade for adults, 3 for big kids, period.
He is spot on
ALWAYS USE MAC4 BLADE!!
ALWAYS USE 7.0 ETT for men and 6.5 ETT for women.
ALWAYS lubricate the stylet and the cuff of the ETT.
ALWAYS keep the head raised above the chest.
ALWAYS keep gum elastic tracheal bougie handy.
ALWAYS chant HARE KRSNA! He would help you.If He doesn't help, you may stop chanting.
Always shut the fuck up and stop giving orders like you were the intubation master of the universe. Thank you
Always throw the stylet away and use bougie on first attempt
Use just the tube.
ALWAYS check a urine pregnancy in any women of child bearing age that comes in with abdominal pain.
Miller blade. Mac blade is terrible.
The everyday practice of intubators around the world would suggest otherwise.
Not to mention the miller blade goes under and puts pressure on the epiglottis, potentially causing epiglottitis