laryngoscopy and fiberoptic bronchoscopy, at least for the time
being."
In fact, the training advantage is one of the most important features
that video scopes offer, says Dr. Piracha. "It's an extremely good
teaching tool, and very useful to understand the basic airway anato-
my," he says. "In fact, whenever I have a super-new trainee in my
operating room who has never done a laryngoscopy, I have them do it
first on a video laryngoscope, so they get an idea of what the anatomy
looks like."
But then it's back to basics, says Dr. Piracha, who agrees that the
time to ditch direct hasn't yet arrived. "You have to remember that, as
with all technology, there's always a chance of failure or unavailabili-
ty," he explains. "What if something happens and your screen breaks
and you can't see anything? I foresee video scopes becoming more
and more prominent, but I think it's still extremely important to be
very proficient with just the traditional handle, light and blade."
3. Point-of-care ultrasound
Pont-of-care ultrasound — PoCUS is what practitioners call it — is
transforming how some providers practice. "It will revolutionize the
way we assess patients," says Dr. Viscusi. "I can put a probe on a
patient and get a pretty good assessment of their cardiac function. I
can scan the stomach of an obese patient or a patient with reflux to
decide whether or not they have a full stomach, and whether I need to
do a rapid sequence [intubation]."
PoCUS is a hot topic in the field, says Eric Schwenk, MD, FASA, an
associate professor of anesthesiology and the director of orthopedic
anesthesia at Jefferson.
"What a lot of us like about it is that it helps to answer a very
focused and simple yes-or-no question — does this patient have a
2 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 9