Today’s Standard of Care
The Essentials
Video laryngoscopes are better than they’ve ever been. The images are cleaner, the screens are brighter, and most of them are easy to turn on and use. That’s all a good thing. But that ease can fool you. Video laryngoscopy gives you more options but also requires that you fully understand the specific device in your hands.
The big thing to remember is that not all video laryngoscopes are the same. We don’t live in a world of one Macintosh blade and one Miller blade anymore. Different platforms come with different blade shapes, ergonomics, image quality, and screen behavior. They may all show you a picture, but they don’t all show the identical view, or behave the same way once things get messy or stressful.
So before you ever use a VL device on a patient, you should be comfortable with the basics of your device. How it turns on. How long the battery actually lasts. What the image does when there’s fog, glare, blood, or secretions. Where the camera sits on the blade, and how that blade is meant to be used.
Battery issues are a classic way for a good airway plan to fall apart. Make it a habit to check the charge and know your backup without having to think about it.
Blade choice matters more than people expect. Macintosh-style VL blades can behave very differently from one another, and many are not meant to be used like traditional direct laryngoscopy blades.
And if you’re using a hyperangulated blade, you’re playing a different game altogether. The view changes, the hand mechanics change, and the shape of the tube you need changes too.
Finally, troubleshooting can’t be something you figure out in the moment. Fog, blood, secretions, poor image balance, these can steal your view fast. Every device has its quirks and its fixes, and you want those to be familiar long before you’re under pressure.
It’s about becoming comfortable with your video laryngoscope so that, when you step up to the bed, the equipment is the least surprising part of the case.
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