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/gottawatchquietones ED Attending 22d ago

DL is really only superior in instances of massive vomiting that keeps getting on the camera. This is rare - I've only had it happen once in several years. But still, it would suck to fail to intubate because of this. That's why I like the Mac blades with a camera on them - I can use them for VL 99.9% of the time, but fall back to DL with a blade geometry that allows it on the rare cases it's needed. Best of both worlds.

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u/sum_dude44 22d ago

I will reluctantly say VL is superior even in cases of vomiting if you suction. And I learned strictly DL in 2010

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u/PerrinAyybara 911 Paramedic - CQI Narc 18d ago

Even more so if you use a large diameter suction like a "Ducanto" or "Big Stick". Otherwise you can take a sz8 ETT pull off the BVM adapter, flip it around and attach to suction.

Massive difference for vomiting airways compared to a yaunker.