The awake Glidescope intubation: an additional alternative to the difficult intubation.

BACKGROUND The incidence of difficult intubations has consistently remained between 8 and 9%. We found a novel approach to the difficult intubation using a Glidescope in the awake spontaneously breathing patient. METHODS In a difficult airway, the same approach for an awake fiberoptic intubation including excellent nerve blocks and sedation can be used with a Glidescope in the same fashion as a fiberoptic bronchoscope. RESULTS The skill level for the awake Glidescope appears to be less, making it a useful tool for emergency room physicians and critical care physicians when used for awake intubation. It is particularly useful for the patient who fails the airway exam and also has macroglossia. CONCLUSION This case report confirms that while not applicable to every patient, the awake Glidescope intubation does add to the previous existing armamentarium in this clinically challenging situation.