professor of anesthesiology at the University of Florida College of
Medicine in Gainesville.
He also suggests looking for systems that have the option for rigid
and flexible fiber optics. Rigid fiber optics are great for most oral intu-
bations, but if your patient has a profoundly flexed neck or cannot
open his mouth more than 2 cm, then having the option for flexible
fiber optics will make sure you can intubate in any scenario.
• Blades. Handheld devices generally have a pre-shaped rigid form
that you slide a disposable plastic sheath over. You'll have to sterilize
reusable blades if you go the non-portable route, but those systems
also come with more sizes and styles of blades, which are easy to dis-
assemble from the video and light sources, notes Ms. Kapelan. Some
blades have a pronounced curvature that lets you visualize an anterior
larynx while others are only slightly better than standard laryngoscopy
for visualizing an anterior larynx, says Dr. Loeb.
• Portability. Because everything is included in the palm of your
hand, you don't have to worry about cables or carts getting in the way
if you go the handheld route. They're great if you're worried about
space or need to intubate on the go. And even though the blades are
disposable, they're also compact, so a small container is all you'll
need to keep them in close range, says Ms. Christian. But the video
carts are not as cumbersome as they sound. Yes, the video screen is
mounted to a rolling supply cart, but it is compact in size and easy
to maneuver, says Ms. Kapelan. You can also store cables, extra
blades and difficult airway accessories on the cart.
• Price. The cost between systems can vary pretty widely, accord-
ing to our experts. Reusable systems tend to be more expensive
upfront and "the cost of cleaning, including personnel, should be
considered in the price of use," says Dr. Loeb. "The handheld device
is cheaper upfront, but costlier in the long run," says Ms. Christian.
J A n u A r y 2 0 1 7 • O U T PA T I E N T S U R G E R Y. N E T • 1 0 9
