# Video Laryngoscope Thread



## CALEMT (Sep 29, 2020)

I guess we’re getting McGrath Video laryngoscopes. Anyone have any experience with them? Good or bad.


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## GMCmedic (Sep 29, 2020)

CALEMT said:


> I guess we’re getting McGrath Video laryngoscopes. Anyone have any experience with them? Good or bad.


They work good, I have trouble manipulating a bougie but with a standard mac 3 and a copilot stylette I have no issue. Ive heard others say the bougie is easier with the xblade. 

The battery indicator is unreliable.


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## StCEMT (Sep 29, 2020)

CALEMT said:


> I guess we’re getting McGrath Video laryngoscopes. Anyone have any experience with them? Good or bad.


McGrath X3 and a bougie is my ****. Thats my go to the vast majority of intubations and it works fantasticly well. Screen isn't on par with what you see in the ED, but the quality is more than enough to know what you're looking at. Just dont expect 4k HD etc.

Obviously be mindful of dirtying your lense, but that goes for any VL. Insert SALAD here. Also keep in mind blade placement for hyperangulated blades like the X3. 

But I absolutely love it and you have the added benefit of being able to do DL with should you want/need. Your learning curve should be simple.


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## StCEMT (Sep 29, 2020)

GMCmedic said:


> They work good, I have trouble manipulating a bougie but with a standard mac 3 and a copilot stylette I have no issue. Ive heard others say the bougie is easier with the xblade.
> 
> The battery indicator is unreliable.


We are bougies only here, but what issues specifically do you run into with it and manipulating the bougie? The copilot stylet I would definitely be interested in trying one day. 

I've done pretty much every bougie method I know of with it. Bonjo, two person transfer, doing the bougie/tube transfer solo, etc.


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## VentMonkey (Sep 29, 2020)

Is there a VL thread? I can’t remember, if not someone should create one and put these comments in it. Pros and cons, I’d be down to share experiences.

Off topic, I sure hope my Boys can muster through this postseason and come out on top. It’s been over 30 damn years.


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## CALEMT (Sep 29, 2020)

GMCmedic said:


> The battery indicator is unreliable.



Shocker. 



StCEMT said:


> We are bougies only here, but what issues specifically do you run into with it and manipulating the bougie? The copilot stylet I would definitely be interested in trying one day.
> 
> I've done pretty much every bougie method I know of with it. Bonjo, two person transfer, doing the bougie/tube transfer solo, etc.



I’m fairly excited to have it in my “toolbox”. Although the area I work (rural farmland) doesn’t see a lot of calls so it’ll be a while when I get to use it. 

Only time I’ve used VL was my OR clinical rotation in medic school and even then it wasn’t close to what’s used in the field setting. It was fiber optics.


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## ffemt8978 (Sep 29, 2020)

VentMonkey said:


> Is there a VL thread? I can’t remember, if not someone should create one and put these comments in it. Pros and cons, I’d be down to share experiences.
> 
> Off topic, I sure hope my Boys can muster through this postseason and come out on top. It’s been over 30 damn years.


Done.


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## CALEMT (Sep 30, 2020)

VentMonkey said:


> Off topic, I sure hope my Boys can muster through this postseason and come out on top. It’s been over 30 damn years.



Stay on topic damn you. Baseball doesn’t belong in the VL thread.


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## VentMonkey (Sep 30, 2020)

We’re still a KV service. I’m channeled only since I still can’t master the ergonomic finesse with a styletted ETT and a non-channeled blade.

We have the old KV, and I’ve been told we’re in the market for either the newest version, or a different VL altogether.

I do believe our manager has scouted the McGrath, but I have no firsthand experience with it, pun intended.


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## DesertMedic66 (Sep 30, 2020)

No experience with them. We are CMAC only. I’ve seen PSFD kill a couple of patients with them.


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## GMCmedic (Sep 30, 2020)

StCEMT said:


> We are bougies only here, but what issues specifically do you run into with it and manipulating the bougie? The copilot stylet I would definitely be interested in trying one day.
> 
> I've done pretty much every bougie method I know of with it. Bonjo, two person transfer, doing the bougie/tube transfer solo, etc.


I'm sure it comes down to technique, I always seem to start out south of the cords and when I manipulate the bougie, I just do circles around the outside edge. It's something I probably need to work on, but Ive had no issues with the copilot to this point.


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## TRSpeed (Sep 30, 2020)

DesertMedic66 said:


> No experience with them. We are CMAC only. I’ve seen PSFD kill a couple of patients with them.



No way! CMAC is awesome hard to believe someone can mess that up lol. With that being said with a CMAC you are able to do DL and VL which is real nice. My only other VL experience was with the KV which I didn’t personally like. With the KV just be careful not to go too deep and get false reassurance seeing the cords, you will see them but it will be very difficult to pass the tube. Unfortunately not all people know that which causes them to miss the intubation.


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## NomadicMedic (Sep 30, 2020)

King vision here. The next replacement is probably tie AirTraq.


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## Carlos Danger (Sep 30, 2020)

CMAC is very good. My favorite for sure, though I haven’t used it in a handful of years. 

The McGrath definitely doesn’t suck. We have them at one of the small rural hospitals that I occasionally cover. Nice and compact; I would imagine great for field use, but otherwise no better or worse than any other VL in my (admittedly limited) experience. 

They are mostly all the same.


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## VentMonkey (Sep 30, 2020)

Carlos Danger said:


> They are mostly all the same.


This. They’re more about the user and their familiarity with the device in hand, and not the device itself.


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## dutemplar (Sep 30, 2020)

We still carry traditional steel, and the McGrath.  Glidescopes are usually available, I'll usually grab one if I can.

I've used the McG a bunch of times, and it is my go to unless I see utter airway hell and I know I'm gonna be tossing a salad and using a shop vac. It's more "normal" than the "blind shifting gears" of the Glidescope. It does seem to target a bit deeper than what I expect it should, and I usually end up inserting pulling back a smidge. The blades are plastic, so it does have more play to it than steel or even the stronger Glidescope blades. If someone's head resembles a bowling ball, it isn't going to be my first choice unless I can really ramp 'em up.

The good: Compact, clear view, nice little protective case, fast to use, "normal" kind of inline use and a bougie or hockey stick will take you home. 

The bad: Not as strong as the other blades, smaller view screen, like all VLs can get FUBAR is you drop it into yukky stuff.


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## VFlutter (Oct 1, 2020)

Really love our new C-Mac 8403XD. Weight and balance takes a bit to get used to but the screen and picture quality is amazing.


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## silver (Oct 1, 2020)

dutemplar said:


> The good: Compact, clear view, nice little protective case, fast to use, "normal" kind of inline use and a bougie or hockey stick will take you home.
> 
> The bad: Not as strong as the other blades, smaller view screen, like all VLs can get FUBAR is you drop it into yukky stuff.



To add, you can also DL with a McGrath fairly easily if needed.


I like Mcgrath the best out of the video scopes. Its versatile, light weight, has a low profile, and their view is angulated enough to get you out of trouble when you need it. However the view is narrow as mentioned (always watch your tube go into the mouth and don't look at your screen) and the color/saturation washes out with use.


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## Tigger (Oct 2, 2020)

I like the McGrath, have had access to it for most of my paramedic career and therefore am probably most comfortable with it. It feels like laryngoscope in your hand and doesn't seem to need as much change in technique if you're used to DL. I appreciate having different blade sizes (goes to a 1 if you're still doing pedi ETT) as well as a hyperangulated option. I have not had a need for the X blade but I am sure it's out there. I also like that you can use it for DL but honestly I often forget this when the camera gets nasty and resort to another option. Once I learned the whole SALAD technique deal that issue went mostly away, as it does for all VL. 

Logistically I like that we can keep all of our supplies for it (blades, extra battery, cleaning wipes) in a small pelican case. There is no reason to be bringing it on every call I don't think anyway. The batteries are a lil' pricy though. It is also easy enough to clean. 

Also use the KingVision at another job. Once you get the technique with the channeled blade it feels like you aren't even intubating it's so easy...right up until you get the occasional patient who the channel doesn't work for (combined with my skillset). That's another thing I like about the McGrath, while it may not be as easy to use as the KV all the time, it gives you some flexibility in technique. I do not like that there is really no solution for storing the rather bulky blades (only the camera unit gets a case). 

Used a glidescope (Ranger and others) a few times as well, felt like the McGrath but with a screen not on the handle. I'm sure that's easy to get used to.


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## jgmedic (Oct 2, 2020)

Wow! The bear bit the bullet and bought you guys VL's! That's awesome. Means I can go to my Chief and play the hey, well Cal Fire got em card.


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## CALEMT (Oct 2, 2020)

jgmedic said:


> Wow! The bear bit the bullet and bought you guys VL's! That's awesome. Means I can go to my Chief and play the hey, well Cal Fire got em card.



Typical bear fashion they were supposed to be in the field yesterday...


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## DesertMedic66 (Oct 2, 2020)

CALEMT said:


> Typical bear fashion they were supposed to be in the field yesterday...


Please say you guys are getting some actual hands on training and instruction on them before using them in the field?


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## jgmedic (Oct 2, 2020)

I hope it was like the instruction on the BIG gun


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## CALEMT (Oct 2, 2020)

DesertMedic66 said:


> Please say you guys are getting some actual hands on training and instruction on them before using them in the field?



It's the state what do you think.


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## DesertMedic66 (Oct 2, 2020)

CALEMT said:


> It's the state what do you think.


Ooh. Glad to hear you guys will be getting excellent hands on training with these products before being put into use haha.


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## Bullets (Oct 3, 2020)

NomadicMedic said:


> King vision here. The next replacement is probably tie AirTraq.


Strongly recommend you dont do that, AirTraqs suck, we are replacing them with the McGrath as well


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## NomadicMedic (Oct 3, 2020)

Bullets said:


> Strongly recommend you dont do that, AirTraqs suck, we are replacing them with the McGrath as well



well, since I took the new job it became someone else’s problem.


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## medichopeful (Oct 5, 2020)

We use the channeled KV at my part-time job.  It's great for easy airways.

At my full-time job, we use the GlideScope GO both Mac blades and LoPro (hyperangulated) blades.  I like the LoPro blades, they work fairly well.


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## VentMonkey (Oct 6, 2020)

Relevant podcast:








						FlightBridgeED
					

FlightBridgeED offers the most successful and trusted learning system for passing, and maintaining your FP-C, CCP-C, and CFRN advanced certifications.




					www.flightbridgeed.com


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## CANMAN (Nov 9, 2020)

CMAC on the aircraft F.T. & UE Scope on the ground P.T.

CMAC wins hands down over any VL device I have put my hands on.


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