The most common blades used for direct larynoscopy in pediatrics are the Miller (straight) and Macintosh (curved) blades.
The technique for use of each blade is slightly different and preference depends on the provider.
Many will use the straight Miller blade for infants and small children, and the curved blade for larger children.
This is due to anatomical differences in the infant airway. They have
- A larger epiglottis
- Anterior larynx
- Weaker hypoepiglottic ligaments, meaning the epiglottis is harder to lift from the vallecula