Cite this post as:
Guest Author. Lights Camera Action: Redirecting Videolaryngoscopy (Guest Post). EMCrit Blog. Published on December 9, 2016. Accessed on April 24th 2024. Available at [https://emcrit.org/emcrit/redirecting-videolaryngoscopy/ ].
Financial Disclosures:
Dr. Scott Weingart, Course Director, reports no relevant financial relationships with ineligible companies.
This episode’s speaker(s), (listed above), report no relevant financial relationships with ineligible companies.
CME Review
Original Release: December 9, 2016
Date of Most Recent Review: Jan 1, 2022
Termination Date: Jan 1, 2025
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I don’t fear the day we move on with the evolution of airways. I don’t get a worse phone when the contract is up. I get a better smartphone. I don’t confuse the glidescope with my channeled king vision device. I like my channeled device. I teach my students D.L. but with my king vision I can use on all my patients especially with Ducanto’s salad…aka. gastric diversion. And wish I could if I didn’t have to teach them d.l.
Amazing insights here. Having a Plan A, B & C approach harkens back to your previous article on anti-fragility. The main problem with technological advancements is in our becoming dependent upon them. There are so many variations in airway anatomy that what may be ideal in one patient scenario can fail in another. There is also the possibility of equipment failure. Recently I plugged in the Glidescope preparing for an incoming respiratory failure and got a blank screen and found an orange tag from engineering stating it was pending repair. It is for similar reasons that the US Naval Academy… Read more »
I had a case of an obese man with a big neck, we used VL and couldn’t visualize the cords despite multiple attempts. Switched to DL and cords were easily visible. Sometimes VL adds more clutter and doesn’t always give you a better view.
Moab, I think if there is one thing George’s piece makes clear, it is that VL is a useless term. If you mean hyperangulated blade, then sure that is possible, but usually it is b/c of user technique. If it is VL mac, then that of course can’t be the case as they are the exact same blade. If you mean VL mac, you couldn’t see on the screen but could see using VL Mac directly, then that happens all the time and is not a failure but a planned use of VL mac.
The biggest issue with videolaryngoscopy is that in many centres you have non-experts teaching people to be non-experts. The success rates for relatively straight forward airways are high enough that few have the motivation to truly become expert in the device before teaching others. In the high volume centres where most research is done, this may not be as applicable as it is to a lower volume emergency room., but even within anesthesia where the frequency of intubation is higher, many reach a an unnecessarily low ceiling. I am frankly not sure that the various research studies and resulting meta-analysis… Read more »
John
Great points. I tried to write a response and somehow it got lost. Here is a somewhat rambling video reply. https://youtu.be/11kfnc6-BhA
George
George Kovacs MD MHPE FRCP
Professor, Departments of Emergency Medicine,
Anaesthesia, Medical Neurosciences & Division of Medical Education
Director, Clinical Cadaver Program
Dalhousie University, Halifax, Nova Scotia
Medical Director, EHS Lifeflight
Tel. 902 473 2020
Fax. 902 473 3617
gkovacs@dal.ca