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Laryngoscopy Positioning in an Obese Patient

Three Part Question

In [an obese patient requiring laryngoscopy or endotracheal intubation] what [optimal position] correlates with [the greatest likelihood of successful laryngoscopy].

Clinical Scenario

You are required to perform laryngoscopy on an obese patient. As you are preparing you wonder what the ideal position is to give yourself the best chance of successful laryngoscopy.

Search Strategy

Medline 1950-04/08 using the OVID interface, Cochrane Library (2008), PubMed clinical queries
[(exp obesity or exp obesity, morbid) AND (exp Laryngoscopy)]. LIMIT to human AND English

Search Outcome

40 papers found of which only 2 papers were relevant

Clinical Bottom Line

The reverse trendelenburg position may provide more time for laryngoscopy in the morbidly obese patient, however most studies agree that the primary complication is in using a bag valve mask, not in performing laryngoscopy.