PostScript
LETTERS
Table 1 Measurement of size 00 and 0 laryngoscope blades
Variation in size of laryngoscope blades used in preterm newborns Many preterm infants are intubated for breathing support and/or surfactant administration. Intubation attempts in newborns are often unsuccessful.1 2 Laryngoscopes are used to visualise the vocal cords when attempting intubation. To successfully intubate a baby, the operator needs a good view of the larynx and vocal cords. If the blade of the laryngoscope is too short, the vocal cords will not be visualised.3 If the blade is too long, it may cause trauma to fragile structures in the oropharynx. Inadequate views of the vocal cords have been identified as the reason for the majority of failed intubation attempts in the delivery room.1 Poor visualisation of the vocal cords can also increase the duration of intubation attempts, even in the hands of experienced operators.2 Longer intubation times are associated with adverse events, including hypoxaemia, bradycardia and increased intracranial pressure.2 3 The size of laryngoscope blade used depends on the size of the infant. Three sizes of blades are used when intubating newborns: 1, 0 and 00. The Newborn Life Support Course recommends using a size 1 blade for term infants, a size 0 for preterm infants and consideration of a size 00 blade for extremely preterm newborns.4 Other guidelines suggest the size of the laryngoscope blade used should be determined by the infants weight (size 1 for infants >3 kg, size 0 for infants 1– 3 kg and size 00 for infants
LETTERS
Table 1 Measurement of size 00 and 0 laryngoscope blades
Variation in size of laryngoscope blades used in preterm newborns Many preterm infants are intubated for breathing support and/or surfactant administration. Intubation attempts in newborns are often unsuccessful.1 2 Laryngoscopes are used to visualise the vocal cords when attempting intubation. To successfully intubate a baby, the operator needs a good view of the larynx and vocal cords. If the blade of the laryngoscope is too short, the vocal cords will not be visualised.3 If the blade is too long, it may cause trauma to fragile structures in the oropharynx. Inadequate views of the vocal cords have been identified as the reason for the majority of failed intubation attempts in the delivery room.1 Poor visualisation of the vocal cords can also increase the duration of intubation attempts, even in the hands of experienced operators.2 Longer intubation times are associated with adverse events, including hypoxaemia, bradycardia and increased intracranial pressure.2 3 The size of laryngoscope blade used depends on the size of the infant. Three sizes of blades are used when intubating newborns: 1, 0 and 00. The Newborn Life Support Course recommends using a size 1 blade for term infants, a size 0 for preterm infants and consideration of a size 00 blade for extremely preterm newborns.4 Other guidelines suggest the size of the laryngoscope blade used should be determined by the infants weight (size 1 for infants >3 kg, size 0 for infants 1– 3 kg and size 00 for infants
