Glide Scope

[jwk]

Sure, but I just want to see what others think. And I always get what I want! :rofl:

Since that's the way you do it, do you think, or have you seen/heard of it affecting how you guys prepare for an intubation, especially in percieved difficult intubations? As in positioning, bougie, partner at the neck, suction at the ready, etc etc. Or are people just making a quick attempt and going to the Glidescope?

If it's only available for RSI's then maybe that wouldn't be an issue with your service. It's just something that always concerns me about the Glidescope.

Routine use of GlideScopes, particularly as a first-line airway device, is a significant debate in anesthesia circles as well. My concern is like yours - it takes lots of practice to learn and maintain intubation skills, particularly on difficult airways. Using a GlideScope as a first choice device means those skills will deteriorate because you never use them.

GlideScopes are great - I use them several times a week, but I don't use them for every routine intubation. Using a GlideScope does NOT guarantee intubation, and in fact, there are intubations I have gotten through DL that I could not get with the GlideScope.

Newer versions include pediatric sized BUT that is also associated with increased costs due to the different camera head. In pre-hospital work, where many don't use the GlideScope or have limited access to them because of cost, a pediatric sized setup is probably a luxury item. My anesthesia department does not have the pediatric setup.

 

[MedicPatriot]

I just had a failed intubation with the Glidescope. My partner had success.

I saw the cords fine, but I couldnt not get the tube in. everytime it deflected off of the epiglottis and went down into to esophagus. I couldn't maneuever it upwards. I think I know what I did wrong. I think I wasn't deep enough with the blade because it wasnt close to the epiglottis and the vocal cords were a distant view. My partner had a close up view of the vocal cords and epiglottis barely visible.

On the plus side I never used a glidescope on a patient before so it was a good experience. Also I learned that chest compressions didn't affect my view.

 

[Mad Russian]

I like the glidescope but it is not considered first line in my service it is generally only first line with a predicted difficult airway, we have three response trucks in service and we have one glidescope and two kingvision scopes which are also great and more cost effective.

 

[Bosco836]

Having had the opportunity to play with one, I have to say, I'm a huge fan. With that said, the natural concerns about sun, batteries dying, etc. are all valid; however, those aside - its an awesome tool to have in the toolbox.

 

[Craig Alan Evans]

We participated on a small study where medics obtained an airway on four different scenarios: patient in a helicopter supine, on a floor with head against the wall to simulate confined space, sitting up in a car, and routine supine on a bed at waist height. We used three methods: standard oral intubation with laryngoscope, king airway, and glidescope. Each attempt was timed to first breath given with BVM and as you can imagine the king airway was always the fastest but the glidescope smoked standard oral intubation. It's a wonderful innovation.

 

[VirginiaEMT]

Anyone out there using these yet?

The service which runs my school is hoping to get them soon, seems like it would help a lot to increase intubation success rate.

a video:
http://www.youtube.com/watch?v=VG-HFZuMi-A

from what im told they seem to be very expensive, I've heard as much as $10,000 for the scope/monitor. The blades have a cover which is disposable, then the unit is sanitized. Interestingly enough, this service has also gotten away from ET intubation in cardiac arrest, so this device would be used more often for the other conditions which require ET intubation.

Let me know what you think

-Adam

I have used the McGrath and the GildeScope on mannequins and I much prefer the McGrath. I like having the screen ON the larygoscope and less equipment to fool with.