The patient is placed supine and the back of the head is pushed downwards and backwards. The laryngoscope is held in the anaesthetists left hand and inserted into the right side of the patient's mouth. The tongue is displaced to the left.
Moving the blade smoothly over the tongue, the laryngoscope is advanced until the epiglottis comes into view. The tip of the laryngoscope should then displace the epiglottis anteriorly; it helps to lift the lower jaw at this stage.
The arytenoid cartilages, vocal cords and trachea should now be visible. With constant observation, a lubricated cuffed endotracheal tube is passed through the larynx and onwards into the trachea. The cuff of the endotracheal tube is then inflated with a few millilitres of air in order to create an airtight seal. It is mandatory to auscultate in both axillae for good air entry: the oesophagus or right main bronchus may have been intubated.
Access may be improved by passing a gum elastic bougie through to the trachea and then passing an endotracheal tube over this.
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