Your patient requires a definitive airway. Despite you're best preparation and proper positioning of the patient, those cords are nowhere in sight and you're having trouble visualizing where to place that endotracheal tube.

Here are FIVE simple maneuvers that you can add right now to your airway skills to improve your laryngeal view and successfully intubate your patient.

Want a clear view of of the vocal cords? Remember that your path to getting there is finding the epiglottis and seating your blade into the valleculum. Anterior movement of the blade will then engage the hypoepiglottic ligament and will lift the epiglottis and bring the cords into view.

Watch this beautiful video and you'll get the idea. As the hyoepiglottic ligament is engaged, the cords will blossom into view.
http://intensiveblog.com/engaging-hyoepiglottic-ligament/

Link to Video: https://youtu.be/naa_QqV8Ruk

Your goal may be to get a clear view of the vocal cords and the larynx but your path to getting that clear view is finding the epiglottis and engaging your blade into the valleculum, NOT searching for the vocal cords.

In moments of stress during a difficult intubation it may seem that moving closer is better, but aside from increasing the chances of getting blood, vomit or other secretions on your face it does nothing to improve your view.

Instead, lean back. bend your legs slightly and align your sight along the laryngeal axis to get the best view.

Remember you want your line of sight to look directly along the laryngeal axis. Once your patient is in a sniffing position, leaning forward into the mouth just makes this harder. So LEAN BACK!

The intention of cricoid pressure is to prevent aspiration during intubation. The benefit of this maneuver has since come under scrutiny. Whether or not it prevents aspiration, too much pressure applied to the larynx can block passage of your endotracheal tube, as seen on this demonstration.

Link to Video: https://youtu.be/_UruF9QOYrg

Cricoid pressure as a concept may be dead, but this doesn't mean a more thoughtful use of posterior pressure on the larynx can't improve your view. Bimanual laryngoscopy will improve your view along the laryngeal axis.

https://www.youtube.com/watch?v=LgSrtspeONg

In fiberoptic or video laryngoscopy, advancement of the mandible opens the hypo-pharynx and improves laryngeal exposure by expanding the viewing space for tube delivery.

Watch how a simple jaw thrust can improve your view in this video.
https://www.youtube.com/watch?v=p_QM7vjvRYk


Link to Video: https://youtu.be/p_QM7vjvRYk

In the emergency airway, blood, food, vomit and other secretions are always a hazard. Picking up and putting down the suction when badness is welling up from the esophagus can quickly become an exercise in futility. Welcome to the SALAD technique. Suction as much as you can and then just leave it in the esophagus. Wow, what a great idea!

Demonstration of the technique doesn't come until minute 11 in case you just want to see it...
https://vimeo.com/123169076

In the zombie apocalypse, airway management will be more straight forward...
Until then, mastery of these five techniques will give you a better chance of surviving your next intubation.