Nurse Responsibilities During Laryngoscopy: Comprehensive Guide

Laryngoscopy (direct, video, fiberoptic) visualizes the larynx for diagnosis (hoarseness, stridor, foreign body) or intervention (biopsy, intubation, laser). The nurse is integral to safety and efficiency.

Pre-Procedure

1. Education & Consent: Explain procedure, risks (bleeding, perforation, dental injury, reaction), benefits, alternatives. Verify signed consent.
2. NPO Status: Confirm fasting (solids 6h, clears 2h) — aspiration risk.
3. Pre-medication: Antisialagogue (glycopyrrolate), anxiolytic, antiemetic per protocol.
4. Equipment Check: Scope (video/flexible), light source, camera, monitor, recording. Suction, Yankauer, Magill forceps. Emergency airway (difficult airway cart).
5. Monitoring Setup: Continuous SpO₂, ECG, NIBP q5min, EtCO₂ (if sedated).
6. IV Access: Patent, secured; emergency drugs drawn up.

During Procedure

• Position: sniffing (neutral if cervical spine precaution).
• Assist anesthesia: mask ventilation, induction, paralysis if needed.
• Pass instruments (biopsy forceps, brush, needle, laser fiber).
• Suction secretions/blood; maintain clear view.
• Monitor vitals, depth of sedation, airway patency continuously.
• Document: time, scope size, findings, specimens, complications, meds given.

Post-Procedure

• Recovery monitoring until Aldrete ≥9 / fully awake.
• NPO until gag reflex returns (usually 1–2 hr).
• Assess for stridor, hoarseness, bleeding, subcutaneous emphysema.
• Pain management (usually minimal).
• Discharge criteria met + responsible adult escort.
• Complete procedure note; send specimens with requisitions.

Additional Roles

• Patient advocacy, emotional support, family communication.
• Equipment reprocessing (high-level disinfection/sterilization).
• Quality data: complication tracking, turnaround times.

Nurse vigilance prevents "never events" (dental trauma, aspiration, lost foreign body).