Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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Video laryngoscopes have changed the way Joseph Loskove, MD, practices. The chief of anesthesia at Memorial Healthcare System in Hollywood, Fla., used to fear caring for a patient with a difficult air- way. Not anymore. "Now," he says, "I'll go directly to a video laryngo- scope or start off with a conventional laryngoscope and switch to video-assisted intubation if need be." Dr. Loskove tells of a recent experience of working with an anesthe- sia student to sedate a patient. The student made an attempt with a conventional laryngoscope, but couldn't see much of the airway. Dr. Loskove took over, but the view with the laryngoscope wasn't any bet- ter in his experienced hands. "Fortunately we could ventilate the patient," he remembers. "I asked a nurse to grab a video laryngoscope. Thirty seconds later we put it in, had a perfect view of the airway and intubated the patient. The tech- nology makes those situations much less stressful." So should the added safety afforded by video laryngoscopes let you take on patients you otherwise wouldn't have because of concerns about their airways? It's a touchy, oft-debated topic. "Anatomic abnormalities might be easier to handle with a video laryngoscope," says Dr. Loskove, who couches his opinion with the disclaimer that he's a hospital-based provider. "But if you're con- cerned about patients because they're morbidly obese, and you're not sure you'll be able to intubate them without a video laryngoscope, they might not be candidates for surgery in the outpatient setting." Pam Wrobleski, DNAP, MPM, RN, CRNA, CASC, administrator of the Southwestern Ambulatory Surgery Center in West Mifflin, Pa., knows firsthand the importance of investing in a video laryngoscope: She's a nurse anesthetist who keeps her anesthesia skills current by filling in regularly at the bedside. Her facility has been using a device for 8 years. "It's been one of the most significant pieces of equipment we've 1 1 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 1 6