Proof-of-concept - A do-it-yourself videolaryngoscope for under 25$ - A Solution for Lower-Income Countries?

Videolaryngoscopy has become a standard tool for management of the difficult airway. However, prices of commercially available devices range between hundreds and thousands of dollars, limiting its use in lower-income countries. We describe the production of an effective, low cost, Do-It-Yourself videolaryngoscope.

A 5.5mm USB waterproof video-camera was purchased through eBay (Cost 9.53$). Using tools found at the hospital’s maintenance department, we modified a broken McIntosh 4 blade reducing its height and giving it the hyper-acute angle typical of commercially available videolaryngoscopes. The video-camera was attached 4cm proximal to the tip of the laryngoscope blade using rubber bands. A mobile phone connected via the USB was used as a screen.

18 anesthesiologists (experience 1-30 years) participated in a difficult intubation scenario using a SimMan manikin. Intubation difficulty was induced using the manikin’s tongue inflation, trismus, and a tight fitting neck collar. Intubation was performed using a Macintosh #3 blade, GlideScope GVL 4 blade and the DIY blade. We recorded time from blade insertion to successful intubation, Cormack & Lehane laryngoscopic grade and ease of intubation graded on a 0-4 scale, as judged by the intubating anesthesiologist.

Results: Intubation time, C&L laryngoscopy grade and ease of intubation were: 25.4±17 (Mean±SD) seconds, 2.8±0.8 and 1.6±0.8 for the McIntosh blade, 13.9±5.5 seconds, 1.1±0.3,3.3±0.8 for the GlideScope blade, and 13.0±5.0 seconds, 1.1±0.2, 3.6±0.5 for the DIY blade. Results were significantly different between both the GlideScope and DIY Scope and the McIntosh blade and not statistically different between the DIY Scope and the GlideScope.