Laryngoscopy using the McCoy laryngoscope after application of a cervical collar.

A rigid cervical collar was applied to 102 patients under general anaesthesia. Laryngoscopy was performed using a McCoy laryngoscope blade (size 3) initially in the standard Macintosh configuration followed by activation of the distal hinged tip. The two views obtained at laryngoscopy were graded according to standard guidelines. In 46/102 (45.1%) patients the laryngoscopic view was improved by one or more grades. In 10/102 (9.8%) the view was improved by two grades. Difficult laryngoscopy (grade 3 or 4) was encountered in 26/102 patients using the McCoy laryngoscope in the unactivated position (Macintosh configuration). Of these 26 patients, 24 (92.3%) had glottic structures identified (grade 1 or 2) when the distal tip of the laryngoscope blade was activated (p < 0.001). The McCoy laryngoscope significantly improves the view at laryngoscopy in the patient whose neck is immobilised in a rigid cervical collar.