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one lost airway that results in damage can be enormous," he says. "You're look-
ing at a major settlement that will be coming out of somebody's pocket."
Still, expense is bound to be a consideration. "I suppose it's all a cost-benefit
assessment," says Jay Horowitz, CRNA, of Quality Anesthesia Care Corp. in
Sarasota, Fla. "In my eye and plastic surgery practices, where I have all the stan-
dard airway management equipment, I can't really justify the expense." But, he
adds, "Is that a philosophy I'd accept if my loved one suffered the consequences
of not being able to intubate in a crisis? Probably not."
The cost of a state-of-the-art video laryngoscope varies, but is certain to run at
least a couple thousand dollars. "Like anything else, you get what you pay for,"
says Perry Ruspantine, CRNA, APRN, of Anesthesia Professionals in Dartmouth,
Mass., noting that the more expensive offerings are likely to offer greater clarity,
easier handling of both the video screen and the laryngoscope, and faster setup
time and usability on very short notice. Mr. Ruspantine points to several other
features you also need to consider when shopping the options: Is it interchange-
able for adults and pediatrics? Is it reusable? Can it be adapted to several types
and sizes of blades? Does it have battery backup? Is it easy to clean and main-
tain? What kind of warranty does it have? And can you take pictures or videos
while using it? The ability to store visual records can be a crucial asset when
treating challenging patients.
Prepare for the unexpected
"It would be difficult to justify a negative outcome for any intubation or proce-
dure by stating that one of the modern intubating devices was not available,"
says Mr. Ruspantine. If your center intubates patients, he adds, you should have
an alternative to handle-and-blade laryngoscopes.
"You can't put a price on a life," sums up Dr. Randall. "Why would you play
this cavalier game instead of being prepared for the what if? I don't think
there's any justification for not having a video scope on hand."
OSM
