Title: A Miller for All? (submitted by Joshua McClain, MD)<br/>Author: Mimi Lu<br/><a href='http://umem.org/profiles/faculty/185/'>[Click to email author]</a><hr/><p>
The pediatric epiglottis is more "U" shaped, often overlies the glottic opening, and is "less in line with the trachea."<sup>1 </sup>Because of this, it has traditionally been taught that a Miller blade is the ideal laryngoscope.</p>
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Varghese et al compared the efficacy of the Macintosh blade and the Miller blade when placed in the vallecula of children between the ages of 1 and 24 months. The blades provided similar views and suffered similar failure rates. When the opposite blade was used as a backup, it had a similar success rate as the opposing blade.<sup>2</sup> Passi et al also compared these two blades, this time placing the Miller blade over the epiglottis. Again, similar views were achieved.<sup>3</sup></p>
<fieldset><legend>References</legend>
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<span new="" style="font-size:12pt;font-family:" times="">1.<span new="" style="font-stretch:normal;font-size:7pt;font-family:" times=""> </span></span><span new="" style="font-size:12pt;font-family:" times="">Harless J, Ramaiah R, Bhananker S. <span class="il">Pediatric</span> airway management. <i>Int J. Crit Illn Inj Sci.</i> 2014;4(1):65-70.</span></p>
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<span new="" style="font-size:12pt;font-family:" times="">2.<span new="" style="font-stretch:normal;font-size:7pt;font-family:" times=""> </span></span><span new="" style="font-size:12pt;font-family:" times="">Varghese E, Kundu R. Does the Miller blade truly provide a better laryngoscopic view and intubating conditions than the Macintosh blade in small children? <i>Paediatr Anaesth.</i> 2014;24:825-829.</span></p>
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<span new="" style="font-size:12pt;font-family:" times="">3.<span new="" style="font-stretch:normal;font-size:7pt;font-family:" times=""> </span></span><span new="" style="font-size:12pt;font-family:" times="">Passi Y, Sathyamoorthy M, Lerman J, et al. Comparison of the laryngoscopy views with the size 1 Miller and Macintosh laryngoscope blades lifting the epiglottis or the base of the tongue in infants and children <2 yr. of age. <i>Br J Anaesth.</i> 2014;113(5):869-874. </span></p>
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