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/[deleted] 22d ago

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u/OysterShocker ED Attending 22d ago

They are the standard now for most intubations in North America. Most ER and anesthesia residents, for example, will be better at VL than DL.

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u/Eohde Paramedic 22d ago

Even within our EMS system, it’s the standard for all of us paramedics. Any of our older paramedics that are too stubborn to do VL and continue to do manual without a decent reason can expect to sit in front of our medical director.

Being able to record and directly confirm placement, let alone the speed it lets intubation happen has no excuse for it not to be standard even for us. The new McGrath video scopes are extremely affordable and allow for manual intubation if for whatever reason the video is being a problem.

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u/Aviacks 22d ago

I had a new medic on flight refuse to learn VL. Til we got a GCS 3 500# train wreck that the ED failed to intubate several times. I’m like “you got one shot and when you can’t see shit I’m tubing him with the glidescope”, airway was FILLED with dried snot and vomit.

He took one look and went “what the fuck? Okay your turn.” lol. I had to literally PUSH the snot off the vocal cords because it was hardened from mouth breathing 40 times a minute for two hours while snowed on ketamine and haldol, couldn’t suction it even a little.

We spent several hours going over VL technique after that lol. I admire the ones that keep up DL skills and he was quite good at it, I saw him get some obese no neck trainwrecks no problem several times, but one day you find the scenario it isn’t enough even with good positioning and technique.