• Arnim Vlatten, Sharon Litz, Brian MacManus, Sebastian Launcelott, and Chris Soder.
• Department of Pediatric Anesthesia, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada. arnim.vlatten@iwk.nshealth.ca
• Pediatr Emerg Care. 2012 Dec 1;28(12):1317-20.

ObjectivesAirway management in children with cervical spine may make direct laryngoscopy difficult. Video laryngoscopy is an alternative to direct laryngoscopy. The GlideScope video laryngoscope, successfully used in expected and unexpected difficult pediatric airway situations, has not been studied so far in children with cervical spine immobilization.MethodsA total of 23 children underwent laryngoscopy with manual cervical spine immobilization using the GlideScope and a direct laryngoscope (Miller 1 or Macintosh 2 blade). Percentage of glottis opening score, Cormack-Lehane score, and time to best view were recorded.ResultsPercentage of glottis opening score using the GlideScope was 50% (1%-87%) and 90% (60%-100%) using direct laryngoscopy (P < 0.001). Cormack-Lehane score using the GlideScope was 1 (1-2.7) and 1 (1-1) in direct laryngoscopy (P < 0.001). Time to best view with the GlideScope was 21 seconds (12.2-28 seconds) and 7 seconds (6-8.7 seconds) in direct laryngoscopy (P < 0.05). Data are presented as median and interquartile range and analyzed using paired t test.ConclusionsIn simulated difficult pediatric airway, using the GlideScope resulted in a significantly declined view to the glottic entrance. This result is in contrast to studies in children with difficult airway anatomy due to an anterior larynx, where the GlideScope resulted in improved views.

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