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their comeback with effective ventilation."
Dr. Randall provides anesthesia care across the country and relies on the tools
the facilities provide. "If a facility doesn't have a video laryngoscope or some
other kind of video-assisted device, I would think twice about accepting that
assignment."
But that doesn't mean she uses one for every case. It's best to have video
laryngoscopes available in the event of an airway emergency, acknowledges Dr.
Randall, but also make sure your anesthesia providers don't lose the ability to
perform direct laryngoscopy when appropriate. "The problem is people are
reaching for video laryngoscopes when they don't have difficult airways, and
they become somewhat dependent," says Dr. Randall. "You can lose your skill
and level of confidence by using them all the time and not continually perfecting
the art of direct laryngoscopy."
A safe investment
In any facility where sedation
takes place, the ability to intu-
bate and ventilate are essential
skills, and video laryngoscopes
should be viewed as insurance
policies, says Ashish Sinha, MD,
PhD, MBA, vice chair of anes-
thesiology and perioperative
medicine at Drexel University
College of Medicine in
Philadelphia, Pa. "Not having
them is just inexcusable at this
point. It's very hard for anyone
to justify, because the price of
• READY FOR ANYTHING Potentially challenging intubations aren't always
revealed during even the most thorough pre-op airway assessments.
Pamela
Bevelhymer,
RN,
BSN
