Hopefully you will have been following the video laryngoscopy standard of care debate on EMRAP. If you haven’t, airway guru Ron Walls stated a few months ago that video laryngoscopy was the standard of care. He got slammed and had to back up a bit.
My much less expert opinion is with Ron. While video laryngoscopy is not standard of care yet, it should be. If you have a video laryngoscope, eg a Glidescope or C-Mac, in your department but chose to use an old-fashioned laryngoscope and there is a failed intubation and a poor outcome how are you going to defend yourself and how are you going to live with yourself?
And if you haven’t got a video laryngoscope in your department, why not? If I could get one into our back water ED 2 years ago, you can get one.
Personally I’m a C-Mac fan for ease of use and the ability to use it as a direct laryngoscope if there is too much blood and secretions down the hole to get a good video view.
Use a video laryngoscopy for every intubation so that everyone is familiar with it – rather than trying to get the hang of it when confronted with a difficult intubation. The whole team can see what is going on down the hole, I can see whether or not my colleague got the tube down the right hole.
That’s my 2c worth.
And a reminder to check that you are getting a good picture through the scope before you use it. Sometimes the techs don’t quite get all the goobies off the video lens – give it a wipe with an alcohol swab and you are back in action.