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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u/Final_Reception_5129 ED Attending 22d ago

I have no issues with VL. I DO have issues with trainees never learning important things that we HAD to know with DL (patient positioning, how to use a bougie, cric pressure, etc). These are skills that you need if you do intubations on 400lb COPD patients or 4 day old premies. EM docs need ALL THE SKILLS, not less.

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u/Alarming_Middle_721 22d ago

Agree wholeheartedly. VL allows a high success rate without optimization- easy to get good at intubating with bad technique. I use VL almost exclusively and with a hyperangulated blade most of the time- but I learned appropriate positioning and optimization by learning with DL or standard geometry VL with the screen flipped to my attending in training. That has proven invaluable to me and I’m sure to my patients.