Miller laryngoscope

Description

The Miller laryngoscope is a straight blade designed to obtain a view of the vocal cords by directly lifting the epiglottis. It has useful application in ‘floppy’ airways making it popular within paediatric anaesthesia. The Miller laryngoscope is the most commonly used blade today.


History

Miller found traditional straight blades to be too thick at the base and too short increasing the risk of trauma to the teeth. Miller modified the laryngoscopes popular at the time to make tracheal intubation “easier and more certain”. The Miller laryngoscope has a straight blade with a long, curved tip, providing better exposure of the larynx. This made difficult intubations easier to perform, especially prior to muscle relaxant use and minimised dental trauma.

Miller designed his blade by making it straight and longer than the old style medium blade, rounded at the bottom and smaller at the tip with an extra curve two inches from the end. This made difficult intubations easier to perform and minimised dental trauma. He found this suitable for all patients; except children.

In 1946, Miller developed a blade for use in children. He recommended that tracheal intubation under direct visualization was preferable to the common practice of blind passage facilitated by digital palpation of the epiglottis.

Miller designed his blade by making it straight and longer than the old style medium blade, rounded at the bottom and smaller at the tip with an extra curve two inches from the end. This made difficult intubations easier to perform and minimised dental trauma. Initially only the size 2 (medium) was used. Since then laryngoscopes from size 0 (for premature) to 4 are available.

2017 Oxiport® is a Miller laryngoscope providing apnoeic laryngeal oxygenation in neonates and infants during intubation. Dias et al, demonstrated decreased rates of severe desaturation during intubations in these population groups when using the Oxiport

2018 Alter et al found that in the prehospital setting has shown higher first attempt and overall successful intubation rates when using a curved blade over straight blade


Associated Persons

Alternative names
  • The Miller blade

References

eponymictionary CTA

eponymictionary

the names behind the name

British doctor working in Emergency Department and exploring Western Australia

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