Florida State Paramedic Practice Exam

Where should the tip of a Macintosh laryngoscope blade be placed during intubation?

1. On the epiglottis

2. In the trachea

3. In the vallecula

4. At the base of the tongue

The correct answer is: In the vallecula

The tip of a Macintosh laryngoscope blade should be placed in the vallecula during intubation. The vallecula is the space located between the base of the tongue and the epiglottis. Positioning the blade in this area allows for optimal lifting of the epiglottis, thereby providing a clear view of the vocal cords and facilitating the passage of an endotracheal tube. When the blade is inserted into the vallecula, the curved design of the Macintosh blade effectively displaces the epiglottis upward with minimal trauma, which is crucial for visualizing the airway structures directly. This approach is generally preferred in practice, as it enhances the chances of successful intubation with reduced risk of airway injury. Using the other placements can lead to complications. For example, placing the blade directly on the epiglottis may obstruct the view more than it helps, and placing it in the trachea is not feasible since direct access to the trachea should occur after visualizing the vocal cords. Additionally, positioning the tip at the base of the tongue may not provide sufficient visualization of the airway, as this does not allow the necessary elevation of the epiglottis. Therefore, placing the tip in the vallecula is