Intubation Blades

[bigj164019]

Now I won't make a habit of reposting others threads from Firehouse, but I felt this deserved its place here, and must give "eng41ine2001" from firehouse credit for originally asking;

Which Blade do you perfer, Miller, or Mac, (size) and why?

[IAMedic]

I prefer the straight blade. I hate the curved because it seems as if I am constantly twisting and jamming. The straight blade, I can insert, pull back and seem to find it better. Depending on the person is what I decide on the size.

[hageremtp]

I use a straight blade most of the time! I start each shift by making sure the Miller 3 is in place. I know, 3 is for horses, but I perfer longer than shorter. With that being said, if I need the Mac, I know they are there!

[Paramedic503]

I'm with you all!! Miller all the way!!!

BTW, anybody tried the new Grandview blade yet? It works very well. Sure they're a bit pricey, but well worth the extra $$ in my book. :)

[emtp2031]

I guess I'm the odd man out...I prefer the Mac...most of the providers around here seem to go more for the Mac over the Miller...must be a Md thing :?

[sfd178]

Okay, the odd man out now has a partner. I like the Mac 3. Luckily, the medics on the other 2 shifts prefer the Mac also, so we don't have to change it daily to preference. So, south Alabama likes the Mac too.

[OARMedic]

As a general rule, I like the Miller. I do use the Mac on pts with malformed anatomy, i.e. some MR pts. I have found that, around here, guys like the Miller and MOST of the gals like the Mac. Miller is strength/technique and Mac is techniques/strength.

[smurfe]

Guess I will post my response from Firehouse here also: I use the curved one, if that don't work, I use the straight one :wink:

Smurfe :D

[E74_medic]

A "Mac" is great for keeping the tongue out of the way. A "Miller" seems to have the reach needed for airways that tend to be more anterior (i.e. fat people).

That's my story... I'm sticking to it!!!

[drjenmartin]

I'm all for the grand view....thats what we have in our new system and its all i use now

[parabear]

Well when I first started as a medic I was a Miller man all the way. I ALWAYS used a Miller blade, after running into a few problems with difficult intubations, I have now realized that sometimes you have to adapt and change. Now I start with a Miller most of the time but am not against using a Mac blade, And if my partner already had a Mac blade on, I usually don't change it if they can't get the tube.

Barry Hoke
Sussex County EMS
Sussex County, Delaware
www.sussexcounty.net/scems

[ilemtp]

In our service Every Rig is Equipped with the Standard Miller and Mac plus #3#4 Wisconson blades. This is the first blade to be pulled by the vast majority of our medics. Also I have a Grandview Blade and it isnt worth the money.

[NavyMedic]

:wink: I have to agree with the Mac guys. I have always had better luck with it. In our region we carry both Miller and Mac in asst sizes though (in case another Medic hops on the truck, they can use the one of their choosing)

[alsfirefighter]

I'll probably be the last to post on here and no one will read this, but what the hell.

I'm a 4 Mac guy. Most providers in my area are "Mac" people also. Most like the 3, but I like the 4 because if I need the added length I have it and won't have to switch blades.

Although, as I teach, you must be proficient with both, cause if one doesn't seem to be working, try the other.

No disrespect to the Miller gang, especially the couple that are close friends of mine, but around here, and this is partly a humorous stunt I pulled in the back of a bus with a rookie medic, it does seem that fresh out of school medics all boast of their passionate love for the miller blade, and then can't figure out why its somewhat difficult for them to intubate.

The bus story?...OK....you really had to be there but here it goes. I get sent to a pedestrian struck on a 4 lane state road. The ambulance and FD arrived before me and there were 2 medics whom were members of the VAC and on the bus, the patient was in the back, very well packaged, and rookie medic is at the head..doing what I don't know. The other guy whom I'm friends with is getting ready to drop a large bore. Rookie medic says "I tried to tube him, but there is too much gook in his airway." I didn't even say anything just gave him the head rise, yeah ok, nod. Told him to hyperventilate him, and then I got out my 4 MAC, threw his 8.0 across the ambulance and proceded to intubate with a 7.5. Clear picture all the way!! As I'm tubing I say to the rook "you know what your problem is (name inserted here), 1. you have large et tube on the brainitits and 2 all you rookies think you can go around with the miller blade and tube everything, when you get some experience you'll switch to a MAC... (and I said this last part as I pulled the blade out and inflated the cuff while looking at him) .....like the rest of us. :lol:
_______________________
IACOJ Bureau of EMS Chairman
FOOPS Contributing Editor

[bigj164019]

alsfirefighter,

Your too much! :lol: :lol: :lol: :lol: :lol: :lol:

[IAMedic]

*IAMedic looks around at the ceiling and whistling as he reads ALSfirefighter's post* :wink: :P

[hageremtp]

Huh.....my preceptor was like the counter-ALSFF....He taught me to use the miller and leave the Mac to the guys in the OR. I have only used the miller on codes, but have practiced with the mac in OR rotations. And yes, size does matter. I use the miller 4! I just think, in this case, Bigger is better!!!! :lol:

[FFMedic5175]

Miller 2 is my favorite, but I'll vary a little based on the patient size/presentation. Used both in class, but an anesthesiologist I worked with at the hospital got me into the Miller blades.

[KyFiremedic]

I use a Grand View Blade, it is a cross between a Miller and Mac, an VERY bright! It has a gold tip to help you find the edge of your blade. It will tame the fattest of tounges.

http://www2.mooremedical.com/index.cfm?PG=CTL&CS=HOM&FN=ProductDetail&PID=7106

[smaycffd]

I prefer the mac, but I will go straight to the miller if someone has a bigger neck than my leg!

I have tried the blade with the scope on it, not sure if is the Grandview, but I liked it except when you have a rapid temp change or vomit in the throat. I had problems seeing in those circumstances.

Or is the Grandview the WIDE blade and combination Mac/Miller???