I was recently asked to explain the difference between regular and fiberoptic laryngoscope blades. The real difference between fiberoptic and standard bulb style laryngoscopes is not really the brightness. The big difference is the focus. With a regular bulb, the light is reflected back through the filament, which creates a shadow where you need the most light. Ever play with a flashlight in the dark as a kid? Remember the shadow in the middle of the light? Fiberoptics focus the light where you need it.
Standard blades have a small bulb near the distal end of each blade. The handle only contains the electricity (batteries). At the blade connection the handle has a contact point to transmit the energy, through the conducting wire in the blade & into the bulb. A Fiberoptic handle has the bulb in the handle. Then the light (photons) from the bulb are transmitted through a bundle of glass strands compressed in a metal tube. Since the only bulb is in the handle, you are well advised to carry a backup handle when using fiberoptic systems.
There is a new breed of disposable metal fiberoptic blades many now are using. A true fiberoptic blade has many tiny hair-thickness strands of glass compressed into a single bundle. That is how they are able to keep most of the photons aligned inside the bundle around corners. Because these new metal disposable blades only have a single plastic "stick" for a light transmission bundle, I think they leak light out of the sides and deliver less illumination than a true fiberoptic blade. Actually, the brightest light of any blade I’ve seen is the Rusch Disposable Plastic Lite Blade. It works on a standard handle. Because they buried the bulb in plastic that contains the heat, they were able to use a very bright bulb. The only complaint I’ve heard about it is that the Miller style of the Lite is less robust than the upgraded E-Mac style.Few EMS providers know about any blade styles other than Mac or Miller. There are many others worthy of consideration that I described in an earlier post. Any wide flat blade will work better on the street. Consider blade style separate from illumination system. If your service already has fiberoptic handles, you might consider better fiberoptic blade styles. If you don’t, check out and compare both types of illumination side by side, THEN look at what blades you want. Most hospitals converted to fiberoptic blades years ago. I hope this helps explain the difference between regular & fiberoptic laryngoscope systems.