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(a)
Figure 15.9 The 'sniffi ng the morning air' position in which the neck is
slightly fl exed with the head extended. This allows a direct line of vision from
mouth to vocal cords.
Box 15.2 Anatomical landmarks as you advance laryngoscope
The tonsillar fossa : with the laryngoscope over the right side of
the tongue, advance until the end of the soft palate appears to
meet the lateral pharyngeal wall at the tonsillar fossa.
Uvula : push the tongue into the midline by moving the
blade to the left. Using the posterior edge of the soft palate
as a guide, advance the scope until the uvula is identifi ed in the
midline.
Epiglottis : advance the laryngoscope further over the base of the
tongue until the tip of the epiglottis comes into view.
The laryngoscope should end up sitting in the vallecula. This is
the area between the root of the epiglottis and the base of the
tongue.
(b)
(c)
(d)
Figure 15.11 Step-by-step guide: orotracheal intubation. (a) Insertion of
the laryngoscope making sure to avoid causing damage to the teeth.
(b) Laryngoscopy with cricoid pressure. (c) Inserting the endotracheal tube.
(d) The endotracheal tube secured with a tie.
Figure 15.10 Correct position of the laryngoscope when sited in the
vallecula.
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