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- Mar 19, 2003
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Here is a thought - why do we use laryngoscopes? I'm being serious. Why not do every tube in the ED via fiberoptic scope. Here is my thinking - almost every M&M I have been to in EM has a case that goes something like "we assessed the need to intubate the patient and decided to perform RSI. Thyromental distance was good, Mallampati score and Cormack grade gave us no cause for concern. However, once intubation was attempted, it was difficult to visualize the cords. Three attempts were made with ventilation via BVM between each attempt. Intubation was finally achieved via gumbogie stick".
Now, I realize that fiberoptic is difficult to set up as a "crash" backup when things are going to $hit, but why not start with it. The failure rates of fiberoptic intubation are extremely low (orders of magnitude below laryngoscopy), if the unit is setup as the primary intubation tool there are no additional costs in time or risks to the patient, so why not acknowledge the emergent nature of intubation in the ED and start with the best tool for the job?
Just a thought...
- H
Now, I realize that fiberoptic is difficult to set up as a "crash" backup when things are going to $hit, but why not start with it. The failure rates of fiberoptic intubation are extremely low (orders of magnitude below laryngoscopy), if the unit is setup as the primary intubation tool there are no additional costs in time or risks to the patient, so why not acknowledge the emergent nature of intubation in the ED and start with the best tool for the job?
Just a thought...
- H