[Use of Bullard intubating laryngoscope in emergency room]

A sixty-year-old male patient with caries of the cervical spine suffered from cardio-respiratory arrest outside the hospital. Laryngeal mask was inserted into his pharynx and he was brought to the emergency department of our hospital under CPR by emergency paramedical staffs. Endotracheal intubation was tried three times with a Macintosh laryngoscope but was unsuccessful. His neck was difficult to extend and his epiglottis was not visible at all (X-ray photograph showed the fusion and the significant backward protrusion of his cervical spine). EGTA and Combitube were tried but in vain. At last Bullard intubating laryngoscope with videocamera system was operated. An endotracheal tube was easily inserted into his trachea with it and effective cardiopulmonary resuscitation was managed under reliable airway maintenance. These facts indicate that Bullard intubating laryngoscope is valuable at the emergency department and it should be always available there.