Video laryngoscopes

[Spock]

OK, I've been away for a long time but I'M BACK!  I searched the site for this topic and not finding it, I thought I'd start it.  If the topic is some place that I didn't see, tell me to shut up and we'll move on because I'm an old guy and technology is not my strong suit. 

How may services are using video laryngoscopes and what kind are you using?  I've used the glidescope, C-MAC, King Vision, and McGrath and have very specific thoughts about each.  There are others on the market and I wanted to know what people are using.  Certainly cost is a factor but what does everybody think?    

I'll share my thoughts after reading some opinions.

May the tube be with you.

Spock

[paramedicmike]

I've used both the Glidescope and C-MAC.  The C-MAC I found to use a lot of trained muscle memory with the versatility of the option of a more tranditional versus video laryngoscopy.  It's the video laryngoscope of choice in my ER now.

Interestingly enough, the anesthesiologists in my hospital use the Glidescope.  I actually like the Glidescope and have had excellent success with it.  The learning curve is certainly different as it's a different approach.  I've found that some of the weaker intubators (yet another topic entirely) did not do so well with the Glidescope.  Of course, there were plenty of other issues involved.  Though, I think the different approach with the hardware and mechanics of the rigid stylet were problematic for those in question.

I've not used the McGrath on a live patient.  Practicing on a manikin, however, was easy and I did like it.

Nice to see you back.

 

edit: punctuation

Edited February 26, 2016 by paramedicmike

[Off Label]

Glide scope> McGrath > everything else>C-MAC....

[rock_shoes]

I've used both the Glide scope and the King Vision. Out of the two the King Vision required the least muscle memory adaptation versus direct laryngoscopy. The Glide scope was definitely the more versatile tool due to the screen being separate from the blade (making a side on intubation possible in the aircraft). If I had to pick only one I would go with the Glide scope due to the increased versatility.

Within my service ground ALS units carry the King Vision while flight units carry the Glide Scope. This seems to have worked fairly well as ground providers never have to intubate from a non-standard position making the lesser degree of muscle memory adaptation required for the King Vision an advantage.

[ERDoc]

I've used the first and second generation McGraths and the GlideScope but only in the hospital.  I like the Glidescope much better due to the large screen size and the fact that you don't rely on batteries which crap out on you at the worst possible time.  I think it is a bit bulky for the field though.

[Arctickat]

I have a McGrath. Haven't used the others. I found it easier to use it now with a bougie.

[Off Label]

A lot of the folks I work with find that the rigid, stainless steel stylet that Glide scope makes is very useful with the McGrath. Makes using it a lot easier, especially when doing neutral neck intūbations. Disposable stylets can be a bit too flimsy when aiming for the glottis in those situations, IMO.

[Spock]

Thanks for the input everybody.  I think I'll see if we get a few more before I weigh in with my thoughts.  I really wanted to get some idea of how wide spread these devices are in ground EMS because I suspect they have become standard equipment on HEMS.

May the tube be with you.

Spock

[scubanurse]

We have Glide scope in our ED and it is present for every intubation we do.  Most of our docs though intubate by traditional visualization and have the glide scope there to ward off evil spirits.  A few docs use the bougie when having a difficult time visualizing the cords, and they'll do this before they go to the glide scope.  I'll have to talk to them some more to see if they just don't like the glide scope and that's why they don't use it.

I believe our field medics us the same method as I haven't seen them with any video laryngoscopy.  We get nasally intubated patients a lot from one service, which is always fun to deal with. 

[Off Label]

We have Glide scope in our ED and it is present for every intubation we do.  Most of our docs though intubate by traditional visualization and have the glide scope there to ward off evil spirits.  I'll have to talk to them some more to see if they just don't like the glide scope and that's why they don't use it.

 

I think there is a hesitancy of some folks to become less practiced with direct laryngoscopy. The thought being that if the glide scope is over used, that DL skill will weaken. I don't buy it, but some might.