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All participants were able to intubate the difficult airway with a good view of the glottis using the i-scoop. None was able to intubate using seven other laryngoscopes (Macintosh laryngoscope, GlideScope? GVL and AVL, McGrath? (Series 5/MAC), C-MAC?, A.P. Advance?). Intubation was successful only with the Airtraq? (n?=?10), the Airway Scope (n?=?5), the C-MAC D-Blade (n?=?2), the A.P. Advance DAB (n?=?1) and the GlideScope DL Trainer (n?=?1) (p? http://www.selleckchem.com/products/gsk1120212-jtp-74057.html laryngoscope (p? http://www.selleck.cn/products/pd-1-pd-l1-inhibitor-2.html laryngoscope, the ��autoscope��, that already had an electric light source and a blade with a curved and rounded tip (Fig.?1). To view the glottis, Kirstein placed this tip in the vallecula to elevate the epiglottis indirectly. The laryngoscope introduced by Robert R. Macintosh in 1943 (Fig.?1) differs only in that it has a more curved blade [3]; it has since been used as a standard method without undergoing technical changes. Modern videolaryngoscopes have not been able to replace this standard, and all current videolaryngoscopes still have a blade to elevate the tongue base and the epiglottis. In direct http://www.selleckchem.com/products/MDV3100.html laryngoscopy, the blade helps to align the oral, pharyngeal and tracheal axes to allow a direct view of the glottis [1, 2], and it also keeps the oral and pharyngeal cavity open to enable direct tracheal intubation [3]. Videolaryngoscopes do not have to align these axes to the same extent, as the glottis is not seen directly but indirectly via lenses. However, when videolaryngoscopy has to overcome markedly curved anatomy in difficult airways with high bending angles, the glottis may not be visible, even after applying increased and fairly invasive lifting forces. In these very difficult airways, the blade itself prevents optimal positioning of the lenses close to the vocal cords, and thus prevents achievement of the necessary viewing angle for seeing the glottis [4]. Videolaryngoscopes can make intubation of even normal airways difficult, despite a good view of the glottis. These difficulties are mainly due to a lack of experience, or may occur when a malleable stylet is not optimally shaped to reach and to pass the visible glottis [4, 5]. In emergency situations, not less than one in four intubations fails at the first attempt with standard laryngoscopy, and at least one in five intubations still fails initially, even with videolaryngoscopes [5-8].