r/emergencymedicine 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/zimmer199 22d ago

I’ve heard some of my anesthesia colleagues lamenting that their trainees are going for VL on all of their cases, and have had more than a few say DL is going to disappear. And all the naysayers keep bringing up soiled airways and massive hematemesis, but with the SALAD technique and wiping the camera on the patients gown and reinserting two seconds later I’ve never had an issue with camera blockage. I say this as someone who enjoys DL, but yeah, the writing in the wall says VL will become standard in the field, ER, and OR.

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u/bananosecond 22d ago

I think it's bizarre that anesthesiology residents are apparently not being trained appropriately with DL. My group hired an anesthesiologist who was surprised that we didn't have glidescopes in every room and said he had to brush up on his DL skills. To a degree, I understand the allure of VL for EM and critical care since they don't as many opportunities in elective situations to practice. The studies showing superiority of VL are usually in learner or non anesthesiologist practitioners, but as I, and probably you and other DL-proficient EM docs know, essentially everybody can be intubated with DL.