Experience with the McCoy laryngoscope in difficult laryngoscopy

We report our experience with the McCoy levering laryngoscope in 48 patients who were a Cormack and Lehane grade 3 or grade 4 view at direct laryngoscopy. The view with the blade in neutral position was grade 3 in 39 patients and grade 4 in nine patients. Elevation of the levered tip of the blade in the grade 3 group improved the view to grade 2 in 17 patients (44%), in 17 patients (44%) the view remained unchanged and in five patients (12%) the view deteriorated to grade 4. In the patients initially grade 4, the view improved to grade 3 in one patient and remained unchanged in eight patients. The McCoy laryngoscope is a useful tool to aid intubation in about half of patients who are a grade 3 view at laryngoscopy. Our experience indicates it is unlikely to improve a grade 4 view.