DO you video? Emergence of video assisted laryngoscopy in the field.

[SeeNoMore]

I switch VL and DL every other intubation just to keep in practice. I feel there are certain patients that are easier to intubate with DL if the Kingvision is your Video device, but if we had a CMAC I think I would use it every time.

 

[NUEMT]

Just watched a code worked on scene. Not a good experience. Fire /medics took 7 trys to finally get the tube. VL and DL were used and there was so little technique used, you would have thought they were amateurs, and not 15 year experienced medics. Not good. PT was judeged to be PEA onscene and then had a good pulse and ekg.... so I am thinking she had a pulse initially. No drugs pushed. I was one second away and then felt a pulse on the wrist. real mess. all it would have take would have been for some good code running practice. Some Rich Levitan Airway pearls, and some fundamentals.

 

[SeeNoMore]

Sounds like a bad call. I have no tolerance for arrogance in this field. Everyone can miss an intubation, the true professional stays calm and does what's necessary and prudent, including choosing another device/method of airway management. I wasn't there and am not saying anything specific about these providers, but it does seem like an opportunity for growth and reflection.

 

[Handsome Robb]

We get one attempt per medic, with two attempts per patient total and that's it. Anything past that and we're in hot water. Only time a medic can re-attempt the intubation is if they were originally successful and the ETT was displaced or failed for some reason and needs to be replaced.


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[RocketMedic]

I think that the particular piece of kit you're using really matters. I prefer the McGrath, but we use Kings here and there's airways that are and aren't appropriate for the Kingvision blade.

 

[Carlos Danger]

Gotta get a Glidescope. Best there is. C-Mac is excellent too, and considerably cheaper, I think.

I use the GS on probably 10% of my intubations in the OR. I would probably use it on 50% of them in the field, and I intubate every single day. If I didn't intubate as much as I do, I'd probably use it on close to 100% of them in the field.

 

[NomadicMedic]

When we were trialing VL systems, I really liked the intubrite. Cost won out though and KingVision was the choice

 

[TXmed]

I think that the particular piece of kit you're using really matters. I prefer the McGrath, but we use Kings here and there's airways that are and aren't appropriate for the Kingvision blade.

I agree with this, the mcgrath and intubrite offer a blade that can be used traditionally for 2 views. Where as the king is to reliant on proper anatomy and structures to offer you one view which has the potential to handicap you in a difficult airway.

 

[RocKetamine]

We just got the Intubrite VL at my flight job and I use the McGrath and King Vision at my PRN jobs. My personal preference is McGrath > Intubrite > King Vision. The McGrath beats both in image quality, compactness, and ease for initial DL use, however the biggest drawback (for some) is the lack of recording options.

The KV is the cheapest base cost but with the blades being $40ish each compared to the McGrath blades being $10 the savings might be cancelled out in the long run.

 

[WuLabsWuTecH]

I think the arguments that one is better than another is just silly. The best one is the one that YOU PERSONALLY are most comfortable with and that YOU PERSONALLY have the best success with. If you can hit 99/100 with DL but only 80/100 with VL, and I'm the opposite, then it doesn't matter what the statistics and research data say about the average provider. We are not averages!!!

I personally prefer DL, but a lot of people prefer VL and that's ok. First time using VL for me was a disaster. I was a 4th year medical student and my attending wanted me to try it. Never having practiced with it before in any sort of meaningful way (yes, I'd held one and used it on a dummy, but it was more just checking it out than any sort of deliberate practice) it was very disorienting. Anytime I wanted to reposition the blade the entire screen moved and I'd have to re-orient myself. Through some miraculous fluke, I got the tube, but not due to any real skill. I still use VL from time to time, but really just to keep my skills up and so if a medical student or someone training under me is struggling with it and we need a tube quick, I can take over and get it without needing to change equipment.

A large part of it is also just knowing your own limitations. I can use a laryngoscope, take one look at an airway and say to myself, "Well, if I were on dry land I could probably land this, but no way in heck this is happening in the back of a moving medic." and then grab for an LMA instead.

 

[RocKetamine]

I think the arguments that one is better than another is just silly. The best one is the one that YOU PERSONALLY are most comfortable with and that YOU PERSONALLY have the best success with.

Which is exactly what this tread is about, personal preference for the different devices. I haven't seen anyone say one device is the absolute best, they all have instances where they are the better choice over the others for intubation due to variations in design. Information like that is not "silly" to discuss.