During airway management with a Miller blade, once the glottic opening (including the arytenoids) is visible, what is the next step?

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Multiple Choice

During airway management with a Miller blade, once the glottic opening (including the arytenoids) is visible, what is the next step?

When you have a direct view of the glottic opening with a Miller blade, the priority is to secure the airway by passing the endotracheal tube through the vocal cords into the trachea. This is typically done with a stylet to guide the tube as it traverses the glottic opening. After the tube is in place, remove the stylet, inflate the cuff to seal the trachea, and then confirm placement with capnography and clinical checks. Ventilating with a bag-mask at this moment would delay securing the airway, and removing or repositioning the blade would not immediately secure the airway once the glottis is visible.

When you have a direct view of the glottic opening with a Miller blade, the priority is to secure the airway by passing the endotracheal tube through the vocal cords into the trachea. This is typically done with a stylet to guide the tube as it traverses the glottic opening. After the tube is in place, remove the stylet, inflate the cuff to seal the trachea, and then confirm placement with capnography and clinical checks. Ventilating with a bag-mask at this moment would delay securing the airway, and removing or repositioning the blade would not immediately secure the airway once the glottis is visible.

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