Flexible Fiberoptic Bronchoscope

This past Monday we had a difficult airway lab where we practiced anesthetic scenarios with patients who have difficult airways. This means that for some reason it is hard to get the breathing tube in - maybe the patient has a really tiny mouth or a fat tongue or a tumor (or a knife!) in their throat. In this situation we can use a fiberoptic bronchoscope which has a camera on the end that allows us to see into the mouth/throat/trachea and then, once we are sure we are in the right place, we can slide the endotracheal (breathing) tube over the scope into the trachea. Unfortunately, this is easier said than done! The camera lens can get blocked by spit or blood and it requires a good bit of hand-eye coordination to maneuver it where you want it to go. The best way for us to get good at using it is to practice in non-emergency scenarios (like, before you realize that you just put someone to sleep and now you can't pass the tube into their trachea). In that first picture you can see me putting the scope in - I am passing it through the mannequin's nose (because sometimes putting it through a patient's mouth is not an option - what if their jaw is wired shut?) and if you look closely you can see the endotracheal tube loaded onto the scope. In the picture below you can see the screen where the view from the camera on the end of the bronchoscope is projected (don't worry, the picture is MUCH clearer in real life). I have gotten the scope where I want it and I am sliding the tube in over it.