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.

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 »