Editing Tracheal intubation (section)

===Laryngoscopes===
{{Main|Laryngoscopy}}
[[File:Laryngoscopes-Miller blades.JPG|thumb|left|alt=Laryngoscope handles with an assortment of Miller blades|Laryngoscope handles with an assortment of Miller blades (large adult, small adult, child, infant and newborn)]]
[[File:Macintosh Blades.jpg|thumb|left|alt=Laryngoscope handles with an assortment of Macintosh blades|Laryngoscope handle with an assortment of [[Robert Macintosh|Macintosh]] blades (large adult, small adult, child, infant and newborn)]]
[[File:Intubación endotraqueal-8.jpg|thumb|Laryngoscopy]]
The vast majority of tracheal intubations involve the use of a [[viewing instrument]] of one type or another. The modern conventional laryngoscope consists of a handle containing batteries that power a light and a set of interchangeable [[blade]]s, which are either straight or curved. This device is designed to allow the laryngoscopist to directly view the larynx. Due to the widespread availability of such devices, the technique of blind intubation<ref name=James1950/> of the trachea is rarely practiced today, although it may still be useful in certain emergency situations, such as natural or man-made disasters.<ref name=Christod2007/> In the prehospital emergency setting, digital intubation may be necessitated if the patient is in a position that makes direct laryngoscopy impossible. For example, digital intubation may be used by a paramedic if the patient is entrapped in an inverted position in a vehicle after a motor vehicle collision with a prolonged extrication time.

The decision to use a straight or curved laryngoscope blade depends partly on the specific anatomical features of the airway, and partly on the personal experience and preference of the laryngoscopist. The Miller blade, characterized by its straight, elongated shape with a curved tip, is frequently employed in patients with challenging airway anatomy, such as those with limited mouth opening or a high larynx. Its design allows for direct visualization of the epiglottis, facilitating precise glottic exposure.<ref name="Scott2009" />
Conversely, the Macintosh blade, with its curved configuration reminiscent of the letters "C" or "J," is favored in routine intubations for patients with normal airway anatomy. Its curved design enables indirect laryngoscopy, providing enhanced visualization of the vocal cords and glottis in most adult patients.<ref name="Berry2007" />

The choice between the Miller and Macintosh blades is influenced by specific anatomical considerations and the preferences of the laryngoscopist. While the Macintosh blade is the most commonly utilized curved laryngoscope blade, the Miller blade is the preferred option for straight blade intubation. Both blades are available in various sizes, ranging from size 0 (infant) to size 4 (large adult), catering to patients of different ages and anatomies. Additionally, there exists a myriad of specialty blades with unique features, including mirrors for enhanced visualization and ports for oxygen administration, primarily utilized by anesthetists and otolaryngologists in operating room settings.<ref>{{Cite book |title=Clinical anesthesia |date=2017 |publisher=Wolters Kluwer |isbn=978-1-4963-3700-9 |editor-last=Barash |editor-first=Paul G. |edition=Eighth |location=Philadelphia Baltimore New York London Buenos Aires |editor-last2=Cullen |editor-first2=Bruce F. |editor-last3=Stoelting |editor-first3=Robert K. |editor-last4=Cahalan |editor-first4=Michael K. |editor-last5=Stock |editor-first5=M. Christine |editor-last6=Ortega |editor-first6=Rafael |editor-last7=Sharar |editor-first7=Sam R. |editor-last8=Holt |editor-first8=Natalie F.}}</ref><ref name="Scott2009" />

[[Optical fiber|Fiberoptic]] laryngoscopes have become increasingly available since the 1990s. In contrast to the conventional laryngoscope, these devices allow the laryngoscopist to indirectly view the larynx. This provides a significant advantage in situations where the operator needs to see around an acute bend in order to visualize the glottis, and deal with otherwise difficult intubations. [[Laryngoscopy#Video laryngoscope|Video laryngoscopes]] are specialized fiberoptic laryngoscopes that use a [[Digital electronics|digital]] [[active pixel sensor|video camera sensor]] to allow the operator to view the glottis and larynx on a video monitor.<ref name="Wheeler2007" /><ref name="Hansel2022" /> Other "noninvasive" devices which can be employed to assist in tracheal intubation are the [[laryngeal mask airway]]<ref name="Brain1985" /> (used as a conduit for endotracheal tube placement) and the [[Airtraq]].<ref name="Maharaj2007" />