How to Do Orotracheal Intubation Using Laryngoscopy

Orotracheal intubation is a life-saving procedure used to secure a patient's airway, typically during anesthesia, resuscitation, or critical care situations. The most common way to perform it is with the aid of laryngoscopy, a technique that allows healthcare providers to visualize the vocal cords and guide an endotracheal tube into the trachea.

Whether you're a medical student, nurse, paramedic, or emergency physician, mastering laryngoscopy is essential, and practice with realistic simulation models is key.

What Is Laryngoscopy?

Laryngoscopy is a procedure to visualize the larynx (voice box), particularly the vocal cords, which is essential for accurate and safe intubation. There are two main types:

🔹 Direct Laryngoscopy

• Macintosh blade (curved): Inserted into the vallecula to lift the epiglottis.
• Miller blade (straight): Inserted directly under the epiglottis for exposure.

🔹 Video Laryngoscopy

• Uses a built-in camera and screen to enhance visualization, especially helpful for difficult airways or learners in training.

Step-by-Step Guide to Orotracheal Intubation

1. Patient Positioning

• Place the patient in the "sniffing position": head extended, neck slightly flexed.
• For neonates or infants, use a small shoulder roll to align the airway axis.

2. Laryngoscope Handling

• Hold the laryngoscope with your left hand (if you're right-handed).
• Insert the blade from the right side of the mouth, sweeping the tongue to the left.
• Avoid using the teeth or applying downward force on soft tissues.

3. Expose the Vocal Cords

• Macintosh blade: Place in the vallecula and lift upward and forward.
• Miller blade: Advance under the epiglottis to lift it directly.

4. Insert the Endotracheal Tube

• Pass the tube through the vocal cords into the trachea.
• Watch the tube advance and confirm correct placement with:
  • Bilateral chest rise
  • Auscultation of breath sounds
  • Capnography or CO₂ detection

Practice Safely: Use a Neonatal Intubation Trainer

To master this delicate skill, especially on pediatric patients, it's critical to practice on a realistic airway simulator.

🔸 Ultrassist Neonatal Intubation Trainer – Advanced Airway Management Trainer

This model is designed for ET and nasal intubation practice in neonates and infants.

Key Features:

• Anatomically accurate neonatal airway
• Supports Miller and Macintosh laryngoscope use
• Visual feedback via inflatable lung balloons
• Durable for repeated training sessions

🛒 Also explore the full Airway Management Trainer Collection on Ultrassist.com.

Why Hands-On Practice Matters

Intubation success depends on skill, confidence, and familiarity with anatomy and tools. Practicing with a manikin model allows you to:

• Avoid complications (esophageal placement, trauma, hypoxia)
• Train in multiple scenarios, including difficult airways
• Build speed, coordination, and decision-making under pressure

Always Prioritize Patient Safety

If you’re not a licensed medical provider, do not attempt intubation without supervision and formal training. Simulation practice is the safest way to build competence before clinical exposure.

Watch Laryngoscope Intubation Training Video: