I
believe video laryngoscopy is the new standard of care and
should be used during every case. In fact, I'd bet that a decade
from now video laryngoscopy will be the intubation method of
choice. Here's why.
1. Clinical benefits
Video laryngoscopes simplify even the most difficult intubations. You
don't have to open the mouth as wide as you do with direct laryn-
goscopy, meaning there's less risk of damage to teeth and airway
anatomy, and less muscle manipulation.
The devices provide a direct view of the glottic inlet, letting you see
exactly where you're placing the endotracheal tube. They're especially
useful when working around challenging airway anatomy in patients
who are obese or who present with previous airway trauma or anatomi-
cal abnormalities that turn routine intubations into unexpected chal-
lenges.
Every provider has an opinion on video laryngoscopy. Some argue
that it takes longer than the 10 to 20 seconds it takes skilled providers
to secure the airway with direct laryngoscopy. But I've seen providers
who use video laryngoscopes on an every-case basis, and their skills
have improved dramatically over time. If you use video laryngoscopy
once a month, you obviously won't have the same expertise, but like
most skills in the OR, the more you do it, the smoother your motions
will be and the faster your intubations will go.
The devices might also provide peace of mind among your anesthe-
sia team, giving them the confidence they need to safely and effective-
ly manage patients with marginal airways, especially considering intu-
bation red flags aren't always apparent during pre-op screenings.
When intubation with a direct laryngoscope fails, providers can grab a
video laryngoscope to secure the airway instead of making a second
attempt with a direct blade. Why not get it done right the first time
with video assistance?
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