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lar scope, so I placed a video laryngoscope in her mouth, visualized the larynx and
intubated the patient with no problem," he says. "You just throw the disposable
video laryngoscope away afterward. Each device costs about $100, and after I use
one, I go back to my office and put another one in my briefcase."
Dr. Novak may be fond of the enhanced visual capabilities video laryn-
goscopy provides, but he cautions against getting too reliant on the technolo-
gy. "Knowing how to use a traditional metal laryngoscope is a skill we all have
to develop," he says. "I'd say 95% of the time, direct laryngoscopy is easy to do
with a Miller 2 blade, and there's really no cost to it."
Dr. Novak's reusable video laryngoscope of choice costs about $13,000, a
price he considers a relative bargain compared to the alternative.
"Spending $13,000 for a quality video laryngoscope is significantly less
expensive than the cost of a lawsuit you'd have to settle for $10 million for a
patient who died or suffered permanent brain damage because you lost an air-
way," he says. "Why would you want to risk that for $13,000?"
•
Supraglottic airway devices.
Anesthesia practitioners have multiple options
when it comes to supraglottic devices, and many deserve a try, says Dr. Durick.
In particular, he says, the inflatable supraglottic airway device has "changed the
landscape." He has also seen a rise in the popularity of non-inflatable supraglot-
tic devices, which have the potential to be kinder to the patient's airway.
"There's a learning curve with inflatable devices, so you can overinflate them
if you're not careful," he says. "We once had 2 patients come into the ER with
acute epiglottitis one day apart, and it turns out both had had surgery during
which the same anesthesia provider used a supraglottic airway. We had to intu-
bate both patients, because the epiglottis was so swollen it obstructed their air-
ways. There were distinct marks on the epiglottis where the supraglottic airway
had bent it back and cut off the blood supply."
Ready for anything
Video laryngoscopes and supraglottic devices have become the standard of
