In general, there are four types of laryngoscope blades, namely conventional, fiber optic, Heine style, and disposable or temporary-use models. Each has its own primary benefits and is usually best suited for certain nuanced situations. Just the same, talented practitioners can typically use them interchangeably. The traditional or “conventional” blade is perhaps the most interchangeable model, and was the first blade ever developed. Fiber optic blades often offer the most control and tend to be the smallest and most flexible, too; they’re also the most expensive in most scenarios, though, which is often a consideration. The Heine style blade gives the option of attached light, which can help improve accuracy, whereas disposable blades are often the best choice for emergency medicine practitioners in the field who may need the tool at a moment’s notice, but also may not use it for months at a time. The uncertainty doesn’t always justify the cost of owning a top-notch model, and single-use blades can be best for these situations.
Blade Basics
Laryngoscope blades are used to view the vocal cords and the space between the cords, called the glottis. They are used during medical procedures involving the larynx and during tracheal intubation. The blades usually have lights to improve visibility for the doctor and, often, pointed ball tips to help squeeze past the epiglottis to get to the glottis. Others have design considerations that take into account small openings or minimize the risk of damage to the patient's teeth.
Conventional or Traditional Models
The conventional style of blade comes in both curved and straight designs. Both styles come in sizes 0 through 4. Size 0, the smallest blade, is used on babies and very young children, while the largest size, 4, is used on adults. Accessories, such as ports for oxygen and mirrors for added visibility, are available in most cases.
Fiber Optic Blades
A fiber optic blade is lightweight, may be curved or straight, and has a polished finish. The blade can be removed from its handle and replaced with a new blade very easily. Fiber optic models can also be polished so the blade stays in good condition. Depending on the blade brand, fiber-optic blade sizes range from 0 to 5, with 5 being the largest blade. The functioning of these is basically the same as conventional blades, but fiber optic models are often easier to use and maintain.
Heine Style
Heine-style laryngoscope blades also come in curved and straight varieties. They have four handles available, including medium, penlight, stubby and extra-large. The blades are made of 303 or 304 stainless steel and most are all one piece, so there are no crevices or cracks to allow accumulation of debris. Those that have more than one piece are said to be easy to sterilize, though. A fiber-optic bundle in the handle to the left of the Heine-style blade provides bright light and has a long life span. Depending on the brand of Heine-style blade, sizes again range from 0 to 5, with 5 being the largest.
Disposable Options
Disposable blades are stainless steel with a plastic locking mechanism. These blades do not freeze in low temperatures so there is not a problem with the blade sticking to the tongue or mouth. After the blade is used, it can be disposed of and replaced with a new blade. There is a strong, bright source of light coming from the plastic fiber-optic bundle. Disposable blades are generally considered safe and present no danger of any type of cross-infection.
The sizes of disposable blade available again depend on the brand and style but normally range from 0 to 4. Size 0 is used for newborns and premature infants, and size 4 is used on adults. The handles also come in a familiar five sizes — penlight, medium, stubby, large and extra-large. The blades are available in curved and straight design.