r/emergencymedicine • u/Radiant_Alchemist • 22d ago

Advice Will Video Laryngoscopy become the norm?

I love VL. They make standard laryngoscopes look brutal. They're less traumatizing, they give a better view, they have a better first-pass success. Sure you need to learn direct laryngoscopy but let's say in 5 years from now will they be used as routine in OR and ER intubations? Or will they be saved for hard cases?

I've been told that the equipment tends to suck and that we won't have VL as available as in the current department that I'm working so I should stick to Macintosh and McCoy.

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3

u/N64GoldeneyeN64 22d ago

Id love to say VL has never failed me

But its next to useless with vomit/bloody airways. Its useless without a specific stylet if you have a hyperangulated blade. Sure a C-Mac can do both but if you dont know how to do DL, youre still screwed.

And, if you work at shops with less resources that rarely see intubations done, you could be working with something that doesnt work and you wont know until it doesnt turn on.

I think there will be a push going forward for VL only but it will be at the detriment of patients if you arent trained both ways

8

u/Hippo-Crates ED Attending 22d ago

Even in very bloody or vomit airways if you lead with suction and stick it in the goose it goes fine the vast majority of the time. Video should be the standard

7

u/Resuscit8e 22d ago

Yep. This was studied as well. VL > DL for soiled airways. Just don't shove it into the fluids and mess up your camera view.

-4

u/N64GoldeneyeN64 22d ago

Or, you can do DL and not worry that a small piece of carrot that gets stuck on your camera will prevent you from getting the airway

2

u/Hippo-Crates ED Attending 22d ago

Errr sounds like a skill issue tbh

-1

u/N64GoldeneyeN64 22d ago

As in you dont know how to use a DL blade

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u/Hippo-Crates ED Attending 22d ago

lol. Maybe. Sounds like you can’t use a VL blade though

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u/N64GoldeneyeN64 22d ago

I usually use VL. I just dont worry if something goes wrong like suction getting occluded by food or clots