Summary
We studied the laryngoscopic iiiew in 167 patients with their head and necks held in the neutral position with manual in-line
stabilisation and cricoid pressure to simulate the patient with a suspected cervical spine injury. Each patient underwent
laryngoscopy using both a McCoy and a Macintosh laryngoscope. The best oiew obtained by each laryngoscope was graded
according to standard guidelines. The results showed that the McCoy was never worse than the Macintosh. It improrvd the
Macintosh grade by 1 grade in 41 YO and by 2 grades in 8% (j < 0.001). Difficult larvngoscopy, defined as the inability to see
the glottis (grade 3 or 4), was found in 56 (33%) with the Macintosh laryngoscope and only e&hf (Soh) (p < 0.001) with the
McCoy Iaryngoscope. We suggest that patients with a suspected cervical spine injury and a full stomach should he intuhated
using a McCoy in preference to a Macintosh laryngoscope.