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This page describes products and general use; it is not medical advice.
A video laryngoscope is a rigid laryngoscope with a camera at the blade tip and a screen, so airway staff and the people who stock airway equipment see the view the blade sees. This guide covers what the device is, the three blade designs that clinical trials group it into, how the US FDA classifies it, and what the largest trial review found by design. Who uses it: anesthesia and emergency airway teams, and the clinic, hospital and supply staff who specify and stock their equipment.
What a video laryngoscope is
In US regulation, a rigid laryngoscope is “a device used to examine and visualize a patient’s upper airway and aid placement of a tracheal tube” (21 CFR 868.5540, checked 2026-10-30). A video laryngoscope is a rigid laryngoscope that adds a camera and display to that purpose. For the conventional direct version, including its parts, see what a laryngoscope is.
How it is built
The common elements are a handle, a blade that carries the camera and light toward its tip, and a screen, either built into the handle or connected to it. Blades may be reusable or single-use. In one open-access cohort of 4,902 adults, the device studied (TD-C-IV, UE Medical) used single-use, disposable, non-channeled blades in sizes 3 and 4, with 42-degree angulation at the distal tip (BMC Anesthesiology 2025, PMC12649075, checked 2026-10-30). That is one example of one device, not a rule for the category.
Types and variants
The Cochrane review of videolaryngoscopy (Hansel et al., 2022, 222 studies, 26,149 adults) sorts video laryngoscopes into three design groups.
| Design group | What the source says |
|---|---|
| Macintosh-style | Compared with direct laryngoscopy in 61 studies (9,883 participants) |
| Hyperangulated | Compared with direct laryngoscopy in 96 studies (11,438 participants) |
| Channelled | Compared with direct laryngoscopy in 73 studies (7,165 participants); results are in the evidence table below |
Source: Hansel J et al., Cochrane Database of Systematic Reviews 2022, PMID 35373840 (abstract checked 2026-10-30).
US FDA classification and standards
- Rigid laryngoscopes: product code CCW, Class 1 (general controls), 21 CFR 868.5540, 510(k) exempt, Anesthesiology panel (FDA Product Classification database, page updated 2026-10-26, checked 2026-10-30).
- Recognized consensus standards listed by FDA for this code include ISO 7376 (third edition, 2020-08) for laryngoscopes for tracheal intubation, and ISO 7376-2 (first edition, 2025-09) for video laryngoscopes.
- Related codes in openFDA: CAL, non-rigid (flexible) laryngoscope, Class 1, 21 CFR 868.5530; EQN, laryngoscope/nasopharyngoscope, Class 2, 21 CFR 874.4760, where reusable devices need validated reprocessing instructions and validation data in a 510(k) (openFDA classification API, checked 2026-10-30).
Evidence by design
These are population-level results from randomized trials in adults, not advice for any individual patient. Each figure compares video with direct laryngoscopy (risk ratio, 95% confidence interval, certainty as graded by the review).
| Outcome | Macintosh-style video | Hyperangulated video | Channelled video |
|---|---|---|---|
| Failed intubation | RR 0.41 (0.26-0.65), moderate | RR 0.51 (0.34-0.76), moderate | RR 0.43 (0.30-0.61), moderate |
| Hypoxaemia | RR 0.72 (0.52-0.99), moderate | RR 0.49 (0.22-1.11), low; no clear difference | RR 0.25 (0.12-0.50), moderate |
| Oesophageal intubation | RR 0.51 (0.22-1.21), low | RR 0.39 (0.18-0.81), moderate | RR 0.54 (0.17-1.75), low |
| First-attempt success | RR 1.05 (1.02-1.09), low | RR 1.03 (1.00-1.05), low | RR 1.10 (1.05-1.15), very low |
For participants with a known or predicted difficult airway, the hyperangulated comparison for failed intubation gave RR 0.29 (0.17-0.48). The authors concluded that videolaryngoscopy likely provides a safer risk profile than direct laryngoscopy and that video laryngoscopes of all designs likely reduce failed intubation.
Cleaning, reprocessing and single-use blades
FDA’s classification text for the related EQN code states that reusable devices must come with validated reprocessing instructions and validation data. Follow the manufacturer’s instructions for use for each device. For the general framework, see the Spaulding classification and high-level disinfection and sterilization technology.
Common mistakes
- Treating all video laryngoscopes as one design: the Cochrane results differ by outcome between Macintosh-style and hyperangulated groups.
- Assuming blades interchange across brands. Blade sizes and angulation are device-specific; the 42-degree, size 3 and 4 figures above describe one device only. For conventional blade sizing see Macintosh blade sizes.
- Reading trial risk ratios as guarantees for an individual patient or a particular device.
FAQ
What is the difference between direct and video laryngoscopy?
Direct laryngoscopy relies on a line of sight down the blade; video laryngoscopy shows the view on a screen from a camera on the blade. In the 2022 Cochrane review, videolaryngoscopy likely reduced failed intubation compared with direct laryngoscopy (moderate certainty).
Is a video laryngoscope an FDA-regulated device?
Rigid laryngoscopes are Class 1 under 21 CFR 868.5540, exempt from 510(k) premarket notification subject to the limitations in 21 CFR 868.9 (checked 2026-10-30).
Related supplies are listed under emergency and trauma supplies.
Sources
Dates are the day each source was checked.
- 21 CFR 868.5540, Cornell LII, https://www.law.cornell.edu/cfr/text/21/868.5540 (checked 2026-10-30)
- FDA Product Classification, code CCW, https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpcd/classification.cfm?id=CCW (checked 2026-10-30)
- openFDA device classification API, https://api.fda.gov/device/classification.json (checked 2026-10-30)
- Hansel J et al., Cochrane Database Syst Rev 2022, https://pubmed.ncbi.nlm.nih.gov/35373840/ (checked 2026-10-30)
- BMC Anesthesiology 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC12649075/ (checked 2026-10-30)
