# OneScope VL



## NomadicMedic (Apr 23, 2020)

Did anyone play with this one yet? We're getting one to try. Our King Visions are getting a bit long in the tooth.









						OneScope | Video Laryngoscope | PatCen Healthcare
					

Video Laryngoscopy, Intubation, Covid19, Covid-19, and Anesthesia




					www.patcen.com


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## NPO (Apr 23, 2020)

This has peaked our interest. What's the per unit cost?


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## VFlutter (Apr 23, 2020)

Interesting. Looks like a C-Mac clone. Curious how durable it would be, especially the slide and click mechanism. First impression looks a little flimsy.


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## NomadicMedic (Apr 23, 2020)

NPO said:


> This has peaked our interest. What's the per unit cost?



I'll send you a PM.


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## E tank (Apr 23, 2020)

VL has entered the realm of ubiquity....there was a time when it was truly frontier and the design was truly up for grabs (google the Bullard scope). Now its just a variation on a theme that is tried and true and as long as the tweaks stay within established, proven parameters, one is as good as the other.


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## NPO (Apr 23, 2020)

NomadicMedic said:


> Did anyone play with this one yet? We're getting one to try. Our King Visions are getting a bit long in the tooth.
> 
> 
> 
> ...


Please let us know how you like it.

We've been looking for an all-in-one solution for VL. We use King Vision right now, but can't use them for peds, can't use them with magills, and they only have one size.

These have 4 sizes from large adult to neonate. I've also been screaming at VL manufacturers for years to add recording and this one has it. Nice.


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## DesertMedic66 (Apr 23, 2020)

NPO said:


> Please let us know how you like it.
> 
> We've been looking for an all-in-one solution for VL. We use King Vision right now, but can't use them for peds, can't use them with magills, and they only have one size.
> 
> These have 4 sizes from large adult to neonate. I've also been screaming at VL manufacturers for years to add recording and this one has it. Nice.


The CMAC has all of those bases covered also.


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## NomadicMedic (Apr 24, 2020)

DesertMedic66 said:


> The CMAC has all of those bases covered also.



There is a significant cost difference.


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## Carlos Danger (Apr 24, 2020)

NPO said:


> Please let us know how you like it.
> 
> We've been looking for an all-in-one solution for VL. We use King Vision right now, but can't use them for peds, can't use them with magills, and they only have one size.
> 
> These have 4 sizes from large adult to neonate. I've also been screaming at VL manufacturers for years to add recording and this one has it. Nice.


Why can’t you use King Vision with magills?


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## NomadicMedic (Apr 24, 2020)

Carlos Danger said:


> Why can’t you use King Vision with magills?



Lots of places only use channeled blades. Maybe that causes difficulty with magills. I honestly have not used the KV with magills. Anytime I've used them to clear a FBAO, it's been under DL.


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## Carlos Danger (Apr 24, 2020)

NomadicMedic said:


> Lots of places only use channeled blades. Maybe that causes difficulty with magills. I honestly have not used the KV with magills. Anytime I've used them to clear a FBAO, it's been under DL.


I've never used a channeled blade. I've heard reference to them plenty of times but never thought much about what it actually was. I just had to google it to see what it looks like.

Not to take this too far off topic, but what is the point of a channeled blade? Why would anyone design an airway device in such a way as to take up so much space in the airway? Or choose to use one that does? Is i just to avoid needing a stylet?


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## NomadicMedic (Apr 24, 2020)

Carlos Danger said:


> I've never used a channeled blade. I've heard reference to them plenty of times but never thought much about what it actually was. I just had to google it to see what it looks like.
> 
> Not to take this too far off topic, but what is the point of a channeled blade? Why would anyone design an airway device in such a way as to take up so much space in the airway? Or choose to use one that does? Is i just to avoid needing a stylet?



It's really to take the guesswork out of the intubation. If you place an ET in a KV channel and get the correct view, the geometry of the channel puts the tube in the glottic opening every time.  Jeff Jarvis has a great video that shows the technique he teaches for using a KV, and we've adopted it here. It's dramatically improved first-pass success rate for the infrequent intubators that most paramedics (including myself) truly are.


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## NPO (Apr 24, 2020)

NomadicMedic said:


> It's really to take the guesswork out of the intubation. If you place an ET in a KV channel and get the correct view, the geometry of the channel puts the tube in the glottic opening every time. Jeff Jarvis has a great video that shows the technique he teaches for using a KV, and we've adopted it here. It's dramatically improved first-pass success rate for the infrequent intubators that most paramedics (including myself) truly are.


Second. With a channeled blade intubation is beyond easy once you learn the Jarvis method. Several times I've intubated while not even bring in axis with the head, but rather over a shoulder or something. First pass success is near 100% at my department and we use only channel blades.

It's not just the size of the blade that's an issue for McGill, it's the angle. You physically cannot get both a KV and McGill's into the larynx. I know. I've tried.


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## GMCmedic (Apr 24, 2020)

One of my flight medical directors, an anesthesiologist, once said reference recording intubations. 

Do you want to go to a baseball game and learn how the hot dog is made, or would you rather just enjoy the hot dog and the game? 

Im inclined to agree. 

We use the mcgrath, no recording capability but it works.


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## NPO (Apr 24, 2020)

GMCmedic said:


> One of my flight medical directors, an anesthesiologist, once said reference recording intubations.
> 
> Do you want to go to a baseball game and learn how the hot dog is made, or would you rather just enjoy the hot dog and the game?
> 
> ...


I don't understand the analogy. 

Recorded intubations are great to use for coaching when a single provider has low success rates, or for education (burns, hangings, etc)


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## DesertMedic66 (Apr 24, 2020)

NPO said:


> I don't understand the analogy.
> 
> Recorded intubations are great to use for coaching when a single provider has low success rates, or for education (burns, hangings, etc)


Once we fully start to record our intubations this is how we will be using it. Our medical directors will review the videos and offer helpful points. Truly interesting or difficult intubations will be incorporated into a chart review that is offered company wide.


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## NomadicMedic (Apr 24, 2020)

I think snapping a picture  of the tube placed is a decent QA measure that should be standard for any one who uses VL and has the capability


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## VFlutter (Apr 24, 2020)

The new C-Mac's can snap a picture but I do not think they can record. It is nice feature for education and documentation. Love the AirwayCam book and video series.


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## GMCmedic (Apr 24, 2020)

Also understand this was Kentucky where EVERYthing is discoverable. We certainly didnt discount the educational value of it, but he successfuly convinced the higher ups that they dont want a video record of that 1 in 100 intubation.


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## DesertMedic66 (Apr 24, 2020)

VFlutter said:


> The new C-Mac's can snap a picture but I do not think they can record. It is nice feature for education and documentation. Love the AirwayCam book and video series.


If you hold down the multifunction button for a couple of seconds it will start to record. Push the button to end the recording. A quick press of the button snaps a picture.


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## NPO (Apr 24, 2020)

NomadicMedic said:


> I think snapping a picture of the tube placed is a decent QA measure that should be standard for any one who uses VL and has the capability





VFlutter said:


> The new C-Mac's can snap a picture but I do not think they can record. It is nice feature for education and documentation. Love the AirwayCam book and video series.


Snapping a picture is cool. But it doesn't explain how a provider is failing, it can't be used to show SALAD in action. All it does is help confirm placement if you have trust issues with your providers.


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## VFlutter (Apr 24, 2020)

DesertMedic66 said:


> If you hold down the multifunction button for a couple of seconds it will start to record. Push the button to end the recording. A quick press of the button snaps a picture.



Awesome, good to know. We are still rocking the classic


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## DesertMedic66 (Apr 24, 2020)

VFlutter said:


> Awesome, good to know. We are still rocking the classic


We wanted to keep our classic as a back-up and to use for training/PR however the company did a trade in plan to get the new ones discounted so we had to give it up.


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## StCEMT (Apr 25, 2020)

I haven't even heard of it. For many of the ones out now, it seems like they're just reinventing the wheel. Some not really in a good way. Just give me good blade options, good ergonomics, and a quality screen and I am happy.

I can see the educational and QA benefit to recording, but it's not a huge deal to me. I have capno and a continual record of placement. The image quality could definitely be better, but other than that I really like the McGrath. I think it's been over a year since I couldn't successfully intubate someone with it. I can switch between VL/DL, I have pediatric and hyperangulated blades, it's simple to use.... checks all my boxes.


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## NomadicMedic (Apr 25, 2020)

I think recording is a novelty, but I understand that Maryland mandates every intubation be recorded for QA. Seems like a waste.


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## silver (Apr 25, 2020)

NomadicMedic said:


> I think recording is a novelty, but I understand that Maryland mandates every intubation be recorded for QA. Seems like a waste.


Does every failed intubation need to be recorded? LOL


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## NomadicMedic (Apr 25, 2020)

silver said:


> Does every failed intubation need to be recorded? LOL



It would be a great way to see what the problem was. When I talk to providers about why they had a failed attempt, I never get a really good answer. A video would help find training deficiencies.


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## silver (Apr 25, 2020)

NomadicMedic said:


> It would be a great way to see what the problem was. When I talk to providers about why they had a failed attempt, I never get a really good answer. A video would help find training deficiencies.


Makes sense was wondering if it was more a "this shows the tube is in" vs helping figure out why its failed. That being said, I would much rather have a video outside showing positioning and technique as it tells much more than the view you end up with.


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## StCEMT (Apr 25, 2020)

silver said:


> Makes sense was wondering if it was more a "this shows the tube is in" vs helping figure out why its failed. That being said, I would much rather have a video outside showing positioning and technique as it tells much more than the view you end up with.


An exception I'll give is the hyperangulated blades and king visions. You can spot technique errors related to those. The king vision took me multiple attempts at messing with it to get the hang of it.


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## NomadicMedic (Apr 25, 2020)

Yeah, I was always too deep with the king vision. Once I learned the Jarvis tricks I got really comfortable. Adding SALAD and leading with suction was a total game changer.

and I still have guys who don’t believe in it.


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