Do you sweep the tongue in DL?

[Sleeplessbordernights]

Second year anesthesia resident here, currently in a two month long off site ob rotation. Tbh after two months with only spinals and epidurals my DL skills are a lil rusty, I guess it’s bad form but I never sweep the tongue. This week they started making gyn laparoscopic surgeries, so I started intubating again. My mentor here insists I sweep the tongue this Weird way, twisting the Laryngoscope. Im trying but somehow this made it more difficult, any advice?

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[coffeebythelake]

Second year anesthesia resident here, currently in a two month long off site ob rotation. My DL skills are a lil bit rusty after two months of only spinals and epidurals. This week I had some lspsroscopic gyn cases. I never sweep the tongue while performing DL (bad form I know), my mentor here insists I do, he twists the laryngoscope in a weird way and to be fair the view he gets are amazing. Im struggling with this, any advice?

if you are using a MAC blade you sweep the tongue
don't "need to" but it does give you a better view

 

[Mman]

the tongue???

 

[deleted875186]

I’d say it’s less of a “consciously sweep the tongue” and more of a “insert MAC or Miller blade from the right side of the tongue and advance, tongue falling to the left as you do this”

 

[MirrorTodd]

I’d say it’s less of a “consciously sweep the tongue” and more of a “insert MAC or Miller blade from the right side of the tongue and advance, tongue falling to the left as you do this”

Agree with this. I was trying to explain to my resident the other day that it's not really a "sweep". I just told him to "push" it off to the left, it's not Karate Kid.

 

[dhb]

I’d say it’s less of a “consciously sweep the tongue” and more of a “insert MAC or Miller blade from the right side of the tongue and advance, tongue falling to the left as you do this”

Agreed too: i used to think as a resident it didn't matter and would stick the mac blade down the middle. Now that i know better i come in from the right and the tongue swipes naturally.

 

[pgg]

my mentor here insists I do, he twists the laryngoscope in a weird way and to be fair the view he gets are amazing. Im struggling with this, any advice?

Sweeping is sometimes helpful, especially with big tongues.

Twisting is how teeth get broken. Merely touching the teeth with the laryngoscope isn't likely to damage anything, unless as the teeth are in very bad shape already. But the exaggerated near-90-degree twist I see some people do is a problem, because if a flat part of the blade gets between two teeth prior to rotation, there's enormous leverage and one of those teeth is going to break.

 

[Gnarvin]

I always sweep the tongue with a Mac blade but never twist. It is a relatively subtle movement as others have mentioned. I remember when I first was learning, some of the old school attendings tried teaching the exaggerated twist and sweep like you are mentioning but I never liked that. The important thing is for you to do as many as possible and you will learn what works for you.

 

[deleted875186]

Tongue not off to the side can easily make a grade 1-2 view a 2-3. I think the only way to not get the tongue out of the way with a big MAC3 blade is to purposefully go directly midline the whole time.

 

[deleted697535]

Second year anesthesia resident here, currently in a two month long off site ob rotation. Tbh after two months with only spinals and epidurals my DL skills are a lil rusty, I guess it’s bad form but I never sweep the tongue. This week they started making gyn laparoscopic surgeries, so I started intubating again. My mentor here insists I sweep the tongue this Weird way, twisting the Laryngoscope. Im trying but somehow this made it more difficult, any advice?

When did they start making gynae lap surgery? Just this week? Wow... Alert a&a quick

 

[anbuitachi]

i do not sweep the tongue. i use mac 100% of the time. i dont have issues intubating. the blade is designed so most of the tongue end up on the left side anyway if you enter from slightly on right

 

[Sleeplessbordernights]

When did they start making gynae lap surgery? Just this week? Wow... Alert a&a quick

I mean I wasnt assigned to those cases until this week

 

[Sleeplessbordernights]

Agreed too: i used to think as a resident it didn't matter and would stick the mac blade down the middle. Now that i know better i come in from the right and the tongue swipes naturally.

I think i am an that point right now

 

[T-burglar]

Stop using Mac blades