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V I D E O
L A R Y N G O S C O P Y
and endotracheal tube," he explains. "That 2
degrees of freedom has a clear advantage
over placing the tube through a channeled
device, which positions the tube only where
the channel directs it."
Dr. Doyle says the scope position that provides the best view of the airway is not necessarily the position that provides the best intubation. "It's frequently wise to pull back from
the glottis in order to achieve a more distant
view when placing the endotracheal tube," he
says. "If you're too close, the trajectory of the
tube can be unfavorable, and it tends to hit
the anterior tracheal wall."
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No magic bullet
Dr. Stevens believes video laryngoscopes have
become the go-to tool for many young
providers at the first sign of a difficult airway.
But he cautions against false confidence when
reaching for what they think is a magic bullet
for intubation. "Take a step back and realize
that video laryngoscopy isn't an airway
panacea," he says. "It's not a guarantee that
you'll get a great view and get in. Pre-op evaluation of the airway and proper planning are
still airway management's essential elements."
OSM
E-mail dcook@outpatientsurgery.net.
O C T O B E R 2013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E
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