Will Video Laryngoscopy become the norm?

[u/Radiant_Alchemist]

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.

[u/Zentensivism]

In 🇺🇸👨‍⚖️💸 you argue that a superior modality was not utilized on your first attempt when a case goes poorly?

[u/writersblock1391 → u/Zentensivism]

I mean the superior modality is the one you're more facile with.

I'm probably an outlier here in that I'm relatively young (graduated in 2020) and still DL for >80% of my airways. I legitimately am faster with DL and can more easily troubleshoot a difficult airway with a standard geometry blade most of the time.

The backup to digital will always be something analogue. In a world where we have experienced normal saline shortages, benzo shortages, PPE shortages and other supply issues which would be considered austere in most contexts, the presumption that you will always have access to VL and the associated equipment seems short-sighted to me.

[u/ProtectionPolitics4 → u/writersblock1391]

It's statistically not possible to even have that many difficult airways with VL. Almost every airway is very easy as long as you've done the right pre-intubation stuff, if you're using VL.

DL is where you actually need skills to troubleshoot. But why? It just adds patient risk. Just so one day, just maybe one day, you can be more proficient when the power goes out. Chances are that day never comes. And even if it does, the cumulative risk of patients being exposed to DL over the years is far higher.

[u/writersblock1391 → u/ProtectionPolitics4]

DL is where you actually need skills to troubleshoot. But why? It just adds patient risk. Just so one day, just maybe one day, you can be more proficient when the power goes out. Chances are that day never comes. And even if it does, the cumulative risk of patients being exposed to DL over the years is far higher.

Not to put on a tinfoil hat but a year ago we were rationing normal saline because of national shortages. 5 years ago we were rationing PPE. Right now we're rationing ativan. Assuming that you will always have optimal working conditions and access to the most advanced equipment is pretty short sighted.