Health
Macintosh vs Miller Laryngoscope Blades: A Complete Clinical Guide for Airway Management
Macintosh and Miller are the two most commonly used laryngoscope blades in airway management. They are essential tools for visualising the vocal cords during endotracheal intubation and are routinely used by anesthesiologists, emergency physicians, paramedics, EMTs, and critical-care clinicians. Although both blades serve the same purpose, they differ in blade shape, technique, and ideal patient population. Understanding these differences is vital for safe and effective intubation, especially in emergency and high-risk situations.
What Are Macintosh and Miller Blades?
Macintosh and Miller blades are standard laryngoscope blade designs found in most professional airway kits. They are available in multiple sizes, commonly ranging from size 0 to size 4, allowing clinicians to adapt to neonatal, pediatric, and adult airway anatomy. The primary distinction between the two lies in how they interact with the epiglottis to expose the glottic opening.
Macintosh (Mac) Blade
Design and Shape
The Macintosh blade has a curved design that follows the natural contour of the tongue and oropharynx. This curvature allows the blade to sit comfortably in the airway while creating space for tube passage.
Technique of Use
With the Macintosh blade, the tip is positioned in the vallecula, which is the space between the base of the tongue and the epiglottis. When the clinician lifts the handle upward and forward, the tongue base is elevated, and the epiglottis is lifted indirectly. This indirect lift exposes the vocal cords without directly contacting the epiglottis.
Typical Clinical Use
The Macintosh blade is most commonly used in adults and older children, typically those aged three to five years and above. It is also the preferred blade for beginners because it is easier to control and provides a wider working space for endotracheal tube insertion.
Advantages of the Macintosh Blade
The curved design offers more room for maneuvering the tube, reduces the risk of epiglottic trauma, and generally provides a broad view of the airway. Because of its forgiving technique and ease of use, it is considered the standard blade for routine adult intubation.
Miller Blade
Design and Shape
The Miller blade is straight with a slightly curved tip. Its thinner profile allows it to pass easily through narrow oral openings and small airways.
Technique of Use
Unlike the Macintosh blade, the Miller blade is advanced until the tip passes beyond the epiglottis. The epiglottis is then directly lifted and held against the blade, exposing the vocal cords in a more direct line of sight.
Typical Clinical Use
The Miller blade is most commonly used in neonates, infants, and small children under the age of three. Pediatric patients often have a large, floppy epiglottis, which can obstruct the airway view when using a curved blade. The direct lift provided by the Miller blade offers better control in these cases.
Advantages of the Miller Blade
The Miller blade often provides superior visualization in narrow airways and is especially useful in patients with limited mouth opening, dental irregularities, or large tongues. It is also frequently chosen in difficult airway scenarios where optimal glottic exposure is required.
Key Differences Between Macintosh and Miller Blades
The Macintosh blade is curved and lifts the epiglottis indirectly via the vallecula, making it ideal for adults and older children. The Miller blade is straight and lifts the epiglottis directly, which is why it is preferred for neonates, infants, and certain difficult airways. While the Miller blade may provide a clearer view of the vocal cords, the Macintosh blade often offers better overall intubating conditions, especially for less experienced clinicians.
Importance of Blade Choice in Emergency Situations
Selecting the correct laryngoscope blade is a vital decision in emergency airway management. Using an inappropriate blade can lead to failed intubation, prolonged hypoxia, aspiration, or cardiac arrest. This is why blade selection is heavily emphasized in airway training and frequently searched by medical professionals.
Macintosh vs Miller in Medical Training
Medical students, nurse anesthetists, and paramedics commonly study the differences between Macintosh and Miller blades to master blade placement and technique. The Macintosh blade teaches indirect epiglottic lifting through the vallecula, while the Miller blade requires precise control to directly lift the epiglottis. When comparing visualization, the Miller blade often achieves higher POGO scores, but the Macintosh blade tends to have higher first-pass success rates among beginners.
Use in Difficult Airway Scenarios
Recent studies suggest that the Miller blade may offer improved glottic visibility in morbidly obese patients, particularly those with a BMI greater than 44 or a large neck circumference. The Miller blade is also frequently chosen for patients with dental abnormalities or restricted mouth opening due to its slim profile and direct lifting technique.
Common Clinical Questions
For a floppy epiglottis, especially in infants, the Miller blade is preferred because it directly lifts and stabilizes the epiglottis. The Macintosh blade does not normally touch the epiglottis, as standard technique places the blade tip in the vallecula. While the Miller blade often provides a superior view of the vocal cords, the Macintosh blade generally makes tube insertion easier. In adults, a Miller blade may be used in difficult airway cases involving obesity, large tongues, or limited oral access.
Blade Size Selection
For preterm infants around 32 weeks, clinicians commonly use a Miller size 00 or 0. Infants typically require a Miller size 1. In adults, a Macintosh size 3 is standard for average-sized patients, while size 4 is reserved for larger individuals or deeper airways.
Advanced Technique Considerations
An advanced and less commonly discussed approach involves using a Miller blade with a Macintosh-style technique by placing the blade tip in the vallecula instead of directly lifting the epiglottis. This hybrid method can be useful in select difficult airway cases and highlights the importance of adaptability in airway management.
Final Summary
The Macintosh and Miller blades are not interchangeable but complementary. Mastery of both blades allows clinicians to manage a wide range of airway anatomies safely and effectively. Knowing when to use a curved blade versus a straight blade can significantly improve intubation success and patient outcomes, especially when time and precision matter most.
Entertainment
It’s Not About the Medical cannabis Strain, It’s About the Healthcare System
Strain names can dominate the conversation when it comes to medical cannabis, but they are not what frames treatment in practice. In the UK, cannabis treatments fall inside a medical system built on caution, review and accountability. Once you see how that system works, a lot of the noise around cannabis starts to fall away.
Medical cannabis still carries baggage. For a lot of people, it brings back memories of bad choices, worse people and teenage years best forgotten. That makes it hard to take seriously when it shows up in a doctor’s office. In the UK, medical cannabis does not work on reputation or folklore. It works because it sits inside the same clinical systems as other prescribed medicines, with rules and checks, and people responsible for decisions.
Strain Language Is Where Confusion Usually Starts
The first thing many people hear about medical cannabis is strain names. Indica weed gets talked about as if it has a fixed personality; something calming, something predictable. That idea stuck because it sounds simple and familiar. In practice, it does not carry much weight on its own. Doctors are not working from labels or old stereotypes. They are looking at symptoms, tolerance, previous treatments and how a patient responds once treatment begins. The strain name is a reference point, not a decision-maker.
This is where the gap opens between public language and medical reality. Indica weed means different things depending on dose and formulation, and the person taking it. In a clinical setting, those details shape treatment far more than the word on the label. The takeaway here is to not get hung up on what something should be, but rather on how it actually works at the end of the day.
Medical Cannabis Sits Inside the Same Rules as Other Medicines
In the UK, medical cannabis does not sit outside the healthcare system. It follows the same basic rules as ‘normal’ prescribed medication. That includes specialist oversight in limits on who can prescribe it, and regular review once treatment starts. This structure is set out clearly in NHS guidance on medical cannabis, which places it alongside other controlled treatments rather than lifestyle products.
That framework changes how decisions are made. Prescribing is cautious by design. Adjustments happen slowly and are based on how a patient responds, not on expectations or reputation. The system is there to reduce risk ant to spot problems early, and keep responsibility with trained clinicians instead of leaving patients to figure things out alone. It’s a conservative approach, but one that has the best chance of success.
Patient Experience Reflects Process More Than Product
When patients talk about their experience, they rarely focus on plant types or labels. What comes up instead is how the clinic handled them. Public opinions of cannabis clinics and Curaleaf clinic reviews show these patient experiences in bright daylight. People talk about whether they felt listened to, how follow-ups were handled and how clearly the next steps were explained. Those details drive confidence far more than any strain name ever could.
That feedback points back to process. A clinic that explains decisions and follows a methodological approach leaves a different impression than one that rushes appointments or glosses over concerns. For patients, trust is built through structure and consistency. That is what they remember when they talk about care, not the label attached to the prescription.
Evidence Does Not Support Simple Cannabis Categories
Medical research has never backed the idea that strain labels can predict outcomes on their own. Reviews published in the BMJ make that clear. Effects vary widely between individuals, even when the same product is used. Dose, delivery method, existing conditions and other medications all play a role that strain names do not capture.
This is why clinicians stay careful. Labels may sound reassuring, but they do not replace monitoring and review. In a medical setting, uncertainty is handled through follow-up and adjustment, not confidence in a category. The evidence points away from neat groupings and toward individual response, which is exactly why the system is built around oversight rather than assumptions.
The System Includes People Patients Never Meet
Behind every prescription sits a wider network of healthcare professionals. Pharmacists are part of that structure, even when patients never see them directly. Their role sits inside medicines governance, safety checks, and handling controlled treatments within UK law. The scale and responsibility of that work shows up clearly in pharmacist jobs in the UK, which reflects how tightly regulated medicines are managed.
That matters for medical cannabis because it removes the idea that this is informal or improvised care. Prescribing decisions are supported by systems designed to catch errors and protect patients. Even when the focus feels personal inside a consultation, the treatment still moves through a framework built for accountability, not shortcuts.
Why the System Ends Up Doing the Heavy Lifting
UK medical cannabis only makes sense when you stop treating it like a category and start seeing it as care. The words people recognise tend to come from the street, not the clinic.
What actually shapes outcomes is slower and less glamorous. It is the checks, the follow-ups, the caution, the regulations. When the system works, patients are not asked to rely on guesswork or reputation. They are supported by a process designed to handle uncertainty without pretending it does not exist.
Health
The Various Kinds of Medical Cannabis Oil in the UK – Explained
The term cannabis oil is often used as an umbrella term for any kind of cannabinoid-based oil. But, in the current UK legal framework, the different types can be very different both clinically and legally. Some oils are prescription medicines only available legally from private clinics, where others are available from high street stores or online. They can all be cannabis oil, while being completely different products. Understanding the differences between THC-containing oils, CBD isolate and other extract types is highly important for patients, supplement customers and people in the business alike.
The two main compounds found in cannabis are THC (tetrahydrocannabinol) and CBD (cannabidiol). THC is the psychoactive part of the plant – responsible for the “high” feeling of cannabis as well as therapeutic properties – where CBD is non-psychoactive and more acts as a modulator of various bodily functions. Broadly speaking THC is illegal in the UK without a prescription, whereas CBD is legal for commercial sale. Meaning cannabis oils can be essentially split into THC and non-THC categories. But things are a little more complex than that, as this article will explore.
THC Oils Are Only Available on Prescription
Since 2018, licensed healthcare clinics in the UK are allowed to prescribe THC containing cannabis oils. The NHS is allowed to, but so far has only done so a few dozen times. Nevertheless, some 80,000 patients are currently receiving medical cannabis prescriptions in the UK today. The majority of those choose to treat with vaped flower, but cannabis oils are a starting point for many and clinics are encouraged to suggest them as the first line of cannabis treatment.
Finding a medical cannabinoids dispensary that specialises in sourcing oils could be your preferred treatment option, or you might be interested in the benefits of mixed CBD and THC oil. Either way, an expert comparison site with patient and professional views of dozens of UK clinics is an invaluable resource for patients to find options that suit their needs.
THC containing oils in the UK are produced to pharmaceutical standards, under strictly quality controlled conditions. They can come in various forms such as:
- Full spectrum oils with all the other cannabinoids from the plant like CBD, CBN and CBG plus plant terpenes
- Isolated THC oil
- Isolated THC and CBD mixes of varying degrees
The most common reasons for UK patients to be prescribed THC-based oils are for management of chronic pain, neurological conditions and sleep disorders.
CBD Oils are Legal for Sale Anywhere, But Quality Can Vary
Outside of THC oils, any that are primarily based on CBD are completely legal in the UK. They must have less than 1mg of THC or less than 0.2% of the total product, whichever is lower. Commercially available CBD oils, not prescribed from a clinic, are regulated under the standard for ovel foods and supplements, rather than pharmaceutical regulations. Commercially available CBD oils are also often mixed with aromatics, other supplements and nootropics.
This legal designation also means commercial CBD cannot be marketed or sold as a healthcare product, where prescribed CBD oils can be.
This can lead to some to varying quality standards, inaccurate labelling and other issues. Which doesn’t mean their aren’t great commercial CBD oils and products available – but a cannabis oil review UK customers can trust will always be a useful resource.
Interestingly, CBD containing cannabis flower remains illegal without a prescription. This means most CBD products on the UK market are made with imported CBD from European growers. The UK does produce significant amounts of industrial hemp, a variety of the cannabis flower with naturally low THC that is used in textiles, but the buds are not licensed for use in UK products so farmers currently have to destroy them.
Full Spectrum vs Isolate – What’s the Difference?
That’s covered most of the types of cannabis oils you might find on the UK market today. However, there is one more term that often comes up between clinics, commercially available oils and marketing or labelling of products – and that is full spectrum cannabis oils.
Full spectrum basically means the oil has all the 100 or so cannabinoids and terpenes naturally present in the cannabis plant. The more refined the product, the fewer remnants of the plant remain. These compounds, some of which are of increasing interest to science on their own, include:
- CBG
- CBN
- THCV
- Flavonoids
Confusingly, legal commercially available CBD oils are sometimes called full spectrum despite not containing THC. For treatment with actual full spectrum oil, prospective patients will need to sign up for a private clinic.
This might be of interest because is there some – albeit limited – scientific evidence that full spectrum cannabis oils have slightly different or even increased efficacy when it comes to therapeutic effects. More research is ongoing into this field. It is speculatively called the entourage effect, because the theory is cannabinoid compounds work in entourage with each offer for increased potency.
Celebrity
The Real Story of Hilary Gumbel: UNICEF Advocate, Author, and Bryant Gumbel’s Wife
Hilary Gumbel, formerly known as Hilary Quinlan, is an Emmy Award–winning producer, accomplished author, and internationally recognized philanthropist admired for her humanitarian focus and her long-standing association with UNICEF USA. While many people know her as the wife of legendary journalist Bryant Gumbel, Hilary has built a remarkable identity of her own. Her lifestyle blends media, philanthropy, travel, and global advocacy—earning her respect across nonprofit and entertainment spheres.
With nearly two decades devoted to UNICEF USA, a successful cookbook benefiting children worldwide, and award-winning television production, Hilary represents a modern example of purpose-driven leadership. Her success journey proves that one can merge passion, compassion, and career into a life that helps millions.
Quick Bio
| Category | Details |
|---|---|
| Full Name | Hilary Quinlan Gumbel |
| Profession | Producer, Author, Philanthropist |
| Estimated Net Worth | $1M–$3M |
| Combined Net Worth (with Bryant Gumbel) | $30M–$35M |
| Height | 5’6″ (167 cm) |
| Weight | 58–62 kg |
| Nationality | American |
| Age | Mid-50s (estimated) |
| Known For | UNICEF USA advocacy, UniChef cookbook, Emmy-winning production |
| Spouse | Bryant Gumbel |
| Marriage Date | August 10, 2002 |
| Children | Stepmother to Bradley Gumbel |
| Residence | New York & Florida |
Early Life and Childhood Background
Hilary Gumbel spent several formative years in Nairobi, Kenya, where her father taught at Kenyatta College. This early multicultural experience shaped her worldview, exposing her to global issues and humanitarian needs long before she ever joined UNICEF. Growing up across different environments encouraged her curiosity, resilience, and commitment to leaving a positive impact.
Her childhood overseas is often credited as the beginning of her deep empathy for underserved communities. These early influences later became core to her lifestyle, philanthropy, and international travels as she built her success story.
Education and Financial Career Beginnings of Hilary Gumbel
After returning to the United States, Hilary pursued an education that prepared her for a strong corporate career. She entered the competitive financial sector, working at several brokerage firms. Her most notable corporate role came at Goldman Sachs, where she remained for six years until 1999.
Her financial background strengthened her strategic thinking, discipline, and leadership—skills that later became essential in large-scale nonprofit operations and media production. This phase of her biography reflects the foundation of her early success, demonstrating her ability to excel in high-pressure environments while preparing for a future pivot into global philanthropy.
Transition From Finance to Philanthropy
In 1999, Hilary decided to leave the financial world and redirect her energy toward humanitarian work. This bold shift marked a defining moment in her success story. She began collaborating with UNICEF USA, initially as a senior advisor and later as a national board member.
Her transition is often praised as an inspiring career reinvention—proof that a meaningful lifestyle can evolve at any point, as long as passion and purpose guide the journey. Hilary’s ability to move from finance to global advocacy shows both courage and a deeper desire to improve the world.
Hilary Gumbel’s UNICEF USA Advocacy
Hilary’s most impactful work is undeniably tied to her nearly two decades with UNICEF USA. Joining the national board of directors in 2012, she became a major contributor to fundraising, brand strategy, and ambassador programs. Her role in shaping campaigns, building awareness, and strengthening global outreach has helped UNICEF advance its mission on multiple continents.
Hilary has traveled to Angola, Guatemala, Haiti, Peru, Senegal, Uruguay, and Vietnam, visiting in-country programs that support children’s health, education, and emergency recovery. These experiences refined her approach to humanitarian work and reinforced her deep commitment to advocacy.
Her success in UNICEF represents one of the most respected parts of her biography, defining her lifestyle as one dedicated to upliftment, compassion, and global responsibility.
Media Career and Emmy-Winning Achievements
Beyond philanthropy, Hilary Gumbel has built a solid reputation in television production. As an associate producer on HBO’s Real Sports with Bryant Gumbel, she contributed to the show’s thought-provoking storytelling. Her work earned her a prestigious Sports Emmy in 2021 for Outstanding Sports News/Feature Anthology.
She also produced the television special UniChef: Uniting Through Food and has collaborated with networks such as TLC, Discovery Channel, Peacock, and WarnerMedia. One notable highlight was her leadership in a 2021 Discovery Networks initiative that helped fund 1 billion COVID-19 vaccines for underserved countries.
This blend of creativity, leadership, and humanitarian drive further strengthened her success story, demonstrating how her lifestyle integrates both media and global service.
Authorship and the UniChef Cookbook
In 2013, Hilary published UniChef: Top Chefs Unite, a cookbook featuring recipes from 50 celebrity chefs around the world. The project became a national bestseller, and—true to her philanthropic mission—Hilary donated all royalties to UNICEF.
The book celebrated cultural diversity, global cuisine, and community empowerment. It also became a powerful fundraising tool that supported programs for children in need. Her authorship added a creative dimension to her biography, and it highlighted her dedication to achieving success without compromising humanitarian values.
Awards, Honors, and Humanitarian Recognition
Hilary Gumbel has received major accolades for her work, including:
- Sports Emmy Award (2021)
- Audrey Hepburn Humanitarian Award (2014)
- Honors at the UNICEF Snowflake Ball
These awards are more than achievements—they symbolize her impact, leadership, and commitment to global advocacy. Each recognition strengthens her success narrative and cements her role as one of the most respected philanthropic figures in the United States.
Hilary Gumbel’s Marriage to Bryant Gumbel
Hilary married Bryant Gumbel on August 10, 2002, at The Breakers Hotel in Palm Beach, Florida. The couple became engaged in December 2001 and has since maintained a private, close-knit family life. Despite Bryant’s long and iconic media career, Hilary keeps a warm but low-key lifestyle, avoiding unnecessary publicity.
Hilary is also a devoted stepmother to Bryant’s son, Bradley Gumbel, and remains deeply supportive through her husband’s professional achievements and health challenges. In October 2025, she was by his side when he experienced a medical emergency, reaffirming their strong partnership.
Their relationship reflects loyalty, understanding, and shared values—key themes in their family tree and personal success as a couple.
Personal Lifestyle and Philanthropic Identity
Hilary Gumbel’s lifestyle is elegant, meaningful, and grounded in service. She divides her time between New York and Florida while balancing humanitarian work, media projects, and family commitments. Despite her global travel history, she maintains a modest and intentional personal presence.
Her social media activity is minimal, reinforcing her preference for a quiet private life. Hilary’s lifestyle prioritizes purpose, compassion, and family rather than publicity, making her stand out from many public figures.
Recent Public Appearances and Media Presence
Hilary is often seen at humanitarian galas, UNICEF events, award ceremonies, and red-carpet appearances with her husband. Even with her growing recognition, she maintains a composed, refined approach to public life.
Her career in media production also ensures occasional visibility during industry events, interviews, and philanthropic campaigns. Although she avoids the spotlight, her influence continues to rise because of her achievements—not her social media presence or celebrity association.
What is Hilary Gumbel’s Net Worth?
Hilary Gumbel’s personal net worth is estimated between $1 million and $3 million, derived from her media work, authorship, advisory roles, and long-term philanthropic initiatives. While her focus is not financial gain, her disciplined early career in finance and her strategic philanthropic partnerships have contributed to her stable net worth.
Together with Bryant Gumbel, whose net worth is estimated at $30 million–$35 million, their combined household finances reflect long-term stability and continued success. Her financial story shows the balance between professional achievement and meaningful global impact.
Height, Weight, and Physical Appearance
Hilary Gumbel is known for her graceful presence and polished elegance. Her approximate physical measurements are:
- Height: 5 feet 6 inches (167 cm)
- Weight: 58–62 kg
- Build: Slim, athletic
- Hair: Blonde
- Eyes: Blue
Her appearance complements her professional and philanthropic roles, adding sophistication to her public image.
Family Tree and Personal Connections
Hilary’s family tree includes her husband Bryant Gumbel and her stepson Bradley. Although she does not share biological children with Bryant, she maintains a nurturing presence within the family. Her early life in Kenya, her connection to global cultures, and her humanitarian family values all contribute to the uniqueness of her family tree.
Hilary values privacy, keeping family matters intimate while continuing her global advocacy work.
Hilary Gumbel’s Success Story and Legacy
Hilary Gumbel’s success story is about transformation, empathy, and purpose. From finance to global philanthropy, from authorship to Emmy-winning production, she has consistently aligned her career with meaningful impact.
Her legacy is defined by:
- Long-term UNICEF USA service
- Award-winning media work
- Global cultural advocacy
- Dedication to improving children’s lives
Her story proves that success is not just professional achievement—it is the ability to create positive change through passion, discipline, and compassion.
Conclusion
Hilary Gumbel’s life is a powerful reminder that true success is measured by purpose, compassion, and the impact one leaves on others. From her early years in Kenya to her transformative work with UNICEF USA, she has built a legacy rooted in service and global advocacy. Her award-winning media work, bestselling cookbook, and philanthropic influence reflect a woman who has embraced every chapter of her journey with intention and integrity.
While she is often recognized as the wife of Bryant Gumbel, Hilary shines in her own right as a leader, creator, and humanitarian force. Her balanced lifestyle, steady values, and dedication to improving children’s lives across the world make her a model of modern philanthropy. As she continues contributing to global causes, her family tree, professional achievements, and inspiring story will remain influential for generations to come.
FAQs
What is Hilary Gumbel’s net worth?
Hilary Gumbel’s estimated net worth ranges from $1 million to $3 million.
What is Hilary Gumbel known for?
She is known for her UNICEF USA advocacy, Emmy-winning media work, and bestselling cookbook UniChef.
How long has Hilary Gumbel worked with UNICEF?
She has supported UNICEF USA for more than 18 years and joined the national board in 2012.
Who is Hilary Gumbel married to?
She is married to journalist Bryant Gumbel, whom she wed in 2002.
Does Hilary Gumbel have children?
She has no biological children but is the stepmother of Bryant Gumbel’s son, Bradley.
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