- Bimanual laryngoscopy using external laryngeal manipulation (ELM) is the single most practical and effective airway management technique for facilitating intubation during laryngoscopy.
- During laryngoscopy, the laryngoscopist reaches around with the right hand, manipulating the larynx while directly observing the effect on laryngeal view.
- the force on the neck is in the opposite direction to the force of lift with the laryngoscope.
- After the view is optimized, an assistant maintains pressure at this location, freeing the laryngoscopist’s right hand to place the tube.
- Bimanual technique is more effective than backward, upward, rightward pressure (BURP), or cricoid pressure, applied by an assistant.
References and Links
- Airwaycam — Bimanual laryngoscopy
- ALIEM — Trick of the Trade for Intubation: Two hands are better than one
- MDAware — Bimanual laryngsoscopy