Competing for Space with the GVL

Scott Sturman MD

New Zealand - photo by Tom Yanagi  MD

The conventional reusable Glide Scope is a superior system, however, some institutions have opted to use disposable GVL 3 and 4 Stat Cobalt Ranger equipment.

GVL's wider girth can make insertion of the endotracheal tube more difficult.  In a small mouth the endotracheal tube and GVL compete for space.  In fact despite a good view of the vocal cords during a difficult intubation, it can be difficult to pass the endotracheal tube between the GVL and the patient's teeth and palate.

In these cases after the initial laryngoscopy, the problem can be solved by removing the GVL, inserting the endotracheal tube so the tip rests along the posterior pharyngeal wall, and then reinserting the GVL to visualize the vocal cords.  This avoids the frustration of visualizing the cords but struggling to pass the tube past the cumbersome GVL system and the teeth.