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GlideScope
Anesthesiologist using GlideScope video laryngoscope to intubate the trachea of a morbidly obese patient with challenging airway anatomy. In 2001, the GlideScope (designed by vascular and general surgeon John Allen Pacey) became the first commercially available video laryngoscope. It incorporates a high resolution digital camera, connected by a video cable to a high resolution LCD monitor. It can be used for tracheal intubation to provide controlled mechanical ventilation, as well as for removal of foreign bodies from the airway. The GlideScope owes its excellent results to a combination of five key factors:


 * 1) The steep 60-degree angulation of its blade improves the view of the glottis by reducing the requirement for anterior displacement of the tongue.
 * 2) The CMOS APS digital camera is located at the point of angulation of the blade (rather than at the tip). This placement allows the operator to more effectively view the field in front of the camera.
 * 3) The video camera is recessed for protection from blood and secretions which might otherwise obstruct the view.
 * 4) The video camera has a relatively wide viewing angle of 50 degrees.
 * 5) The heated lens innovation helps to prevent fogging of the lens, which might otherwise obscure the view.

Tracheal intubation with the GlideScope can be facilitated by the use of the GlideRite Stylet, a rigid stylet that is curved to follow the 60° angulation of the blade.[26] To achieve a 99% successful rate of intubation with the GlideScope requires the operator to acquire a new skill set with this stylet.

In a 2003 study, the authors noted that the GlideScope provided adequate vision of the glottis (Cormack and Lehane grade I-II) [27] even when the oral, pharyngeal and laryngeal axes could not be optimally aligned due to the presence of a cervical collar. Despite this significant limitation, the average time to intubate the trachea with the GlideScope was only 38 seconds.[26] In 2005, the first major clinical study comparing the Glidescope to the conventional laryngoscope was published. In 133 patients in whom both Glidescope and conventional laryngoscopy were performed, excellent or good laryngeal exposure was obtained in 124/133 (93%) of Glidescope laryngoscopy patients, compared with only 98/133 (74%) of patients in whom conventional laryngoscopy was used. Intubation was successful in 128/133 (96%) of Glidescope laryngoscopy patients.[28] These early results suggest that this device may be a useful alternative in the management of difficult tracheal intubation.

The Verathon design team later produced the GlideScope Ranger Video Laryngoscope for a United States Air Force requirement that is now rolling forward into EMS and military use. The Cobalt series of Glidescopes then introduced a single-use variant that encompasses weights from 1000 grams to morbid obesity and is successful in many airway syndromes as well. The Glidescope Ranger is a variant designed for use in prehospital airway management including air, land, and sea applications. This device weighs 1.5 pounds, and is IP 68-rated for water resistance, as well as airworthy to 20,000 feet altitude. The GlideScope Cobalt is a variant that has a reusable video camera with light-emitting core which has a disposable or single-use external shell for prevention of cross infection.

In August 2009, the team at Verathon collaborated with Professor John Sakles from the University of Arizona Emergency Department in achieving the world's first tracheal intubation ("telebation") conducted with the assistance of telemedicine technology. During this demonstration, Dr. Sakles and the University of Arizona Telemedicine service guided physicians in a rural hospital as they performed a tracheal intubation using the GlideScope.

Advanced Video Laryngoscopy for the Pediatric Airway
There are several developmental differences between the airway anatomy of an infant, a small child, and that of an adult. In a pediatric patient:

In 2008, the GlideScope Cobalt AVL (advanced video laryngoscope) Preterm/Neonatal was developed with a slimmer profile for pediatric use. Over the next few years, this GlideScope evolved into the AVL Preterm/Small Child, with both reusable and non-reusable plastic blades (called Single-use Stats) for pediatric patients weighing from <1.5 kg to 28 kg. Today, the GlideScope offers anesthesiologists more ways to manage difficult pediatric airways--even the micrognathic pediatric patient (a condition where the jaw is undersized).
 * The head is relatively large compared to the body.
 * The tongue is large relative to the size of the mouth.
 * The larynx is more cephalad (located toward the head) until reaching adulthood.
 * The epiglottis (a flap of cartilage located behind the tongue and in front of the larynx) is narrow and omega-shaped.
 * The vocal cords slant anteriorly and rostrally (toward the oral or nasal region).

To date, there are more cases in the medical literature citing use of the GlideScope in pedatric patients than any other video laryngoscope.