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Intubation of trauma patients often requires careful measures to minimize cervical spine (C-spine) movement. These authors at an academic medical center in Iowa compared C-spine motion during intubation with the Miller and Macintosh blades. Fourteen patients were intubated by one of four experienced anesthesiologists after induction of general anesthesia with neuromuscular blockade. Baseline fluoroscopic images were obtained with the head and neck resting in the neutral position. Additional images were obtained during intubation with both the Macintosh and Miller blades, in random order.
Image quality was sufficient for analysis in 11 patients. All patients were intubated successfully on the first attempt with each blade. All glottic views o…