A junior trainee is taught the difference between the two standard curved and straight laryngoscope blades. Which of the following correctly describes the technique of laryngoscopy using a straight (Miller) blade?
- A The tip is placed into the vallecula and the hyoepiglottic ligament is indirectly lifted
- B The blade is slid along the right side of the mouth and swept the tongue leftwards without contacting the epiglottis
- C The tip is advanced beneath the epiglottis and the epiglottis is lifted directly to expose the vocal cords ✓
- D The tip rests on the posterior pharyngeal wall while the handle is rotated forward
Correct answer: C. The tip is advanced beneath the epiglottis and the epiglottis is lifted directly to expose the vocal cords
Explanation
The Miller blade is inserted so its tip passes behind (beneath) the epiglottis, which is then lifted directly to reveal the glottis. Option A describes the Macintosh technique, where the tip sits in the vallecula and elevation is indirect via the hyoepiglottic ligament; this is the most tempting distractor because students memorise both techniques together. The Miller approach is preferred in infants, whose large floppy epiglottis is better controlled directly.
Reference: Morgan and Mikhail's Clinical Anesthesiology, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.