Do you own your own video laryngoscope?

[cockblockandrun]

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Do any of you own your own portable video laryngscope? i.e. glidescope, pro-vu.

If so, what is the reason you invested in them?

I have been doing only hospital/academic based jobs my entire career and starting to do some locum work in Florida at surgery centers- so I was thinking about investing in one just because Florida is just shady in general.

 

[aneftp]

McGrath videoscope. Don’t buy used/refurbished as there can be some recalled models recirculating on eBay.

$1250 direct from Medtronic sales rep. This is OEM. No third party sales. Direct from manufacturer.

Tell them you are medical provider. That’s the direct rate.

Of course you gotta buy your own spare battery and blades/sleeves…..I will leave it to the moral’s police task force to tell you alternative ways to stock up on plastic sleeves without paying.

I’m not a big fan of the portable teleflex videoscope. It’s better for anterior airways than McGrath (those McGrath have much more than expensive X blade sleeves).

 

[cockblockandrun]

McGrath videoscope. Don’t buy used/refurbished as there can be some recalled models recirculating on eBay.

$1250 direct from Medtronic sales rep. This is OEM. No third party sales. Direct from manufacturer.

Tell them you are medical provider. That’s the direct rate.

Of course you gotta buy your own spare battery and blades/sleeves…..I will leave it to the moral’s police task force to tell you alternative ways to stock up on plastic sleeves without paying.

I’m not a big fan of the portable teleflex videoscope. It’s better for anterior airways than McGrath (those McGrath have much more than expensive X blade sleeves).

Any experience with Provu? I personally found this to have a better video resolution than McGrath.

ProVu Video Laryngoscope | Single-Use and Sterile

ProVu Video Laryngoscope: ready to use in seconds. Wipeable display with sterile, single-use handle and low-profile metal blade are designed for patient safety.

flexicare.com

 

[aneftp]

Any experience with Provu? I personally found this to have a better video resolution than McGrath.

ProVu Video Laryngoscope | Single-Use and Sterile

ProVu Video Laryngoscope: ready to use in seconds. Wipeable display with sterile, single-use handle and low-profile metal blade are designed for patient safety.

flexicare.com

That device the provu is almost like the teleflex video scope with the bigger adapter for the bigger screen. Teleflex screen adapter is actually even bigger at 10 inches.

The provu is nice. The issue is how much with blades/sleeves cost you?

You need to think in terms of parts an availability of blades. It’s like the inkjet or shaving blade business model. The videoscope is just one part of your cost.

If you are routinely using the device. The cost will add up big time if the center you cover doesn’t have the blades. 3-4 cases a day can add up quickly.

I use McGrath because I have rapid access to the blades/sleeves.

 

[PpfSuxTube]

Don't work in places that don't have VL. It's basically standard of care now or @ least very close to it.
If they're gonna skimp on this, forget them

 

[aneftp]

Don't work in places that don't have VL. It's basically standard of care now or @ least very close to it.
If they're gonna skimp on this, forget them

Couple of outpatient places I go to have pretty crappy 2006-2008 barley visible glidescope (the original manufacturer). Feels like the screen quality of the old crt tv. Or the 2013 cmac.

That’s another reason to carry your own if you moonlight so you are more familiar with your own equipment.

 

[cchoukal]

Don't work in places that don't have VL. It's basically standard of care now or @ least very close to it.
If they're gonna skimp on this, forget them

Seriously, what kind of Janky-ass places are you working that don’t have some kind of video laryngoscope? Even our individual room Plastics offices have them.

 

[cockblockandrun]

Seriously, what kind of Janky-ass places are you working that don’t have some kind of video laryngoscope? Even our individual room Plastics offices have them.

Florida.

They have them but are not functional lol.

 

[NicholasPavona]

I just stole one from the surgicenter. They'll never miss it!

 

[aneftp]

I just stole one from the surgicenter. They'll never miss it!

We had 12 McGrath stolen from our trauma main OR area. The second time it happen in 5 years. Definitely some low level house keeping staff reselling them on eBay

The cardiac floor operating suites (3 of them) upstairs and GI area and and other remote location McGrath were not stolen

Which tells u the housekeeping people or someone in the main Or was stealing it. Since the other locations were left untouched

 

[Coffee PRN]

We had 12 McGrath stolen from our trauma main OR area. The second time it happen in 5 years. Definitely some low level house keeping staff reselling them on eBay

The cardiac floor operating suites (3 of them) upstairs and GI area and and other remote location McGrath were not stolen

Which tells u the housekeeping people or someone in the main Or was stealing it. Since the other locations were left untouched

No cameras?

 

[aneftp]

No cameras?

Cameras in hallway etc. but not in operating rooms. McGrath in anesthesia cart but before Pyxis installed last year.

But even in places with Pyxis i use McGrath. I leave the McGrath overnight on the counter occasionally (forgetful) and the other hospital employees do not steal it.

So it’s really an insider doing the stealing at the trauma hospital.

 

[pgg]

I lose my stethoscope about twice per day, and it usually finds its way back to me. Usually. Right now I'm missing the nicer of the two I keep at the hospital.

If I had my own VL it would probably disappear forever within a month.

I don't see a lot of upside to buying equipment the facility should be providing. Worst case it sets the precedent that they don't need to buy things because individual doctors will fill the gaps, and I'm a doctor, not an elementary school teacher.

 

[MirrorTodd]

I have my own Mcgrath, haven't used it in about a year since I just don't need it as places always have a VL in house. What I WOULD like is on of these...Baxter Infus OR Syringe Pump 2L3100 | Biomedix Medical, Inc since GI places for some reason like never have pumps and I kinda hate pushing propofol during anything more than a 5 minute case.

 

[deleted87051]

Florida.

They have them but are not functional lol.

What about the defibrillator?😉

Or is it Plan B (call 911)?

 

[Teillard]

Big problem with disappearing VL's is that there is not a single non-single use anesthesia adjunct left. So the housekeepers or any ancillary personnel new to the OR just assumes they're disposable too. Probably as likely they're being thrown away as being stolen. They just look disposable.

 

[zizzer]

Don't work in places that don't have VL. It's basically standard of care now or @ least very close to it.
If they're gonna skimp on this, forget them

Do you mean standard of care to have available?

Because a lot of non anesthesiologists like to promote that they should be standard of care for every attempt.

 

[dannyboy1]

McGraths definitely like to walk away. OTOH, why does a cheap piece of metal with a camera cost $1200. Can’t someone in china make them for like 50 bucks?

 

[aneftp]

I lose my stethoscope about twice per day, and it usually finds its way back to me. Usually. Right now I'm missing the nicer of the two I keep at the hospital.

If I had my own VL it would probably disappear forever within a month.

I don't see a lot of upside to buying equipment the facility should be providing. Worst case it sets the precedent that they don't need to buy things because individual doctors will fill the gaps, and I'm a doctor, not an elementary school teacher.

Surgery center have the video equipment. Just old video scopes usually

I have my own Mcgrath, haven't used it in about a year since I just don't need it as places always have a VL in house. What I WOULD like is on of these...Baxter Infus OR Syringe Pump 2L3100 | Biomedix Medical, Inc since GI places for some reason like never have pumps and I kinda hate pushing propofol during anything more than a 5 minute case.

I love those old pumps.

 

[cchoukal]

I have my own Mcgrath, haven't used it in about a year since I just don't need it as places always have a VL in house. What I WOULD like is on of these...Baxter Infus OR Syringe Pump 2L3100 | Biomedix Medical, Inc since GI places for some reason like never have pumps and I kinda hate pushing propofol during anything more than a 5 minute case.

I'd kill for a few of those; one of our ASCs has three of those crap Braun syringe pumps. All three programmed differently, all three a tremendous pain in the ass.

 

[PpfSuxTube]

Do you mean standard of care to have available?

Because a lot of non anesthesiologists like to promote that they should be standard of care for every attempt.

Weak attempt. No interest

 

[FiremedicMike]

McGraths definitely like to walk away. OTOH, why does a cheap piece of metal with a camera cost $1200. Can’t someone in china make them for like 50 bucks?

Cost to make is pennies compared to what the FDA needs to “certify” medical devices.

 

[zizzer]

Weak attempt. No interest

Weak attempt at what and no interest in what? I was genuinely wondering what you meant. I agree that it should be standard of care to be available, but I know that there is also a newer movement among intensivists and EM docs promoting VL use for every attempt too.

 

[aneftp]

Weak attempt at what and no interest in what? I was genuinely wondering what you meant. I agree that it should be standard of care to be available, but I know that there is also a newer movement among intensivists and EM docs promoting VL use for every attempt too.

Never use the word standard of care lightly.

Standard of care is hard ingrained.

There are very few standard of care especially in medicine and anesthesiology (for our speciality)

Most are just guidelines.

 

[abolt18]

I have my own Mcgrath, haven't used it in about a year since I just don't need it as places always have a VL in house. What I WOULD like is on of these...Baxter Infus OR Syringe Pump 2L3100 | Biomedix Medical, Inc since GI places for some reason like never have pumps and I kinda hate pushing propofol during anything more than a 5 minute case.

One of my partners has actually built his own syringe pump for propofol infusions. Literally just puts it in, turns one dial, and hits the power button. It only does mL/min, calibrated to our BD 50mL syringes. I think he made a smaller one for smaller syringes as well. He's on something like the 6th iteration of it, but it's even easier to use than the beautiful Baxter pump. We've got a few of those beauties floating around and I love using them.

 

[cchoukal]

Never use the word standard of care lightly.

Standard of care is hard ingrained.

There are very few standard of care especially in medicine and anesthesiology (for our speciality)

Most are just guidelines.

Agreed. Standard of care is mostly a médico-légal term used to hamstring physicians who have a bad outcome. For the most part, governing bodies avoid issuing statements that can be construed by lawyers or expert witnesses as implying or constituting a standard of care. That said, for well over a decade, the VA has stated that a VL for out of OR emergency airway management is, in fact, a standard. Doesn’t exactly apply to the issue at hand, but it’s a strong statement about the importance of availability of VL, in general.

 

[Ezekiel2517]

I've never personally used one but if I needed my own VL, I think I'd give one of those Sensorendo's a shot before a mcgrath. A third of the cost, a rechargeable battery so no need to buy new ones, and way cheaper disposable blades.

And those old school Baxter syringe pumps are the GOAT.

 

[aneftp]

We

I've never personally used one but if I needed my own VL, I think I'd give one of those Sensorendo's a shot before a mcgrath. A third of the cost, a rechargeable battery so no need to buy new ones, and way cheaper disposable blades.

And those old school Baxter syringe pumps are the GOAT.

i read Reddit a lot. It was $1.50 for sensorendo blades. Now it’s $4. That’s a big jump in price in one year. Usually low cost to try to get market share and slowly increase the price is the name of the game.

McGrath blades are $10 each I think and McGrath x blade are a ridiculous $40 each I think for anterior airways.

Saying all this. I’ve never paid a penny of any of this equipment out of my own pocket. It’s always come out out of the university education/cme/equipment funds or hospital funds as a perk.

I do think the institutions should provide it. But the OP is correct. And it’s not just Florida. Many surgery centers are cheap and don’t provide the best equipment. But I’m shocked if they didn’t have any airway video equipment.

A little unrelated comments. Years ago. Amsurg owned facilities. Many of the GI centers didn’t care Succinylcholine because they were too cheap to have to stock MH drugs ($2000 cost). True reason why they didn’t carry succinylcholine. And no anesthesia machines We are talking GI centers that are factories with 10-15k GI procedures a year outpatient. They had roc available (years before suggamadex was available)

So companies are all about cost savings. That Joan rivers gi death. Who knows if sux was even available at that gi center. It’s always been hush hush in that case.

 

[Lecithin5]

We had 12 McGrath stolen from our trauma main OR area. The second time it happen in 5 years. Definitely some low level house keeping staff reselling them on eBay

The cardiac floor operating suites (3 of them) upstairs and GI area and and other remote location McGrath were not stolen

Which tells u the housekeeping people or someone in the main Or was stealing it. Since the other locations were left untouched

I think our McGraths have some sort of tracker on them

 

[Aether2000]

Never use the word standard of care lightly.

Standard of care is hard ingrained.

There are very few standard of care especially in medicine and anesthesiology (for our speciality)

Most are just guidelines.

Standards of care do not require publication, but are the steps taken by a prudent person in a given situation. Not being able to intubate or sustaining an injury to a patient ostensibly due to the unavailability of videolaryngoscopy (given its widespread use), would almost certainly be deemed a breech of the standard of care in a medical malpractice case. Either have VL available or be prepared to be successfully sued for medical malpractice.

 

[aneftp]

Standards of care do not require publication, but are the steps taken by a prudent person in a given situation. Not being able to intubate or sustaining an injury to a patient ostensibly due to the unavailability of videolaryngoscopy (given its widespread use), would almost certainly be deemed a breech of the standard of care in a medical malpractice case. Either have VL available or be prepared to be successfully sued for medical malpractice.

Again. You mis use the world standard of care.

What attorneys look for is local practice guidelines. Remember. Juries are locally selected. The attorney will say does x and x surgery center have vidoescopes.

That’s why you want to have same or similar equipment as hospitals when you do anesthesia. But it’s not a standard.

I mention Amsurg and lack of sux in their GI facilities due to their cheapness of maintaining MH carts. Amsurg circumvented that “standard” by giving providers roc as alternative to largyspams. This is before Suggamadex for you young people. Would you argue sux is the “standard” medicine for largyspams?

 

[Aether2000]

Again. You mis use the world standard of care.

What attorneys look for is local practice guidelines. Remember. Juries are locally selected. The attorney will say does x and x surgery center have vidoescopes.

That’s why you want to have same or similar equipment as hospitals when you do anesthesia. But it’s not a standard.

I mention Amsurg and lack of sux in their GI facilities due to their cheapness of maintaining MH carts. Amsurg circumvented that “standard” by giving providers roc as alternative to largyspams. This is before Suggamadex for you young people. Would you argue sux is the “standard” medicine for largyspams?

No, my use is 100% accurate. You believe that unless there is a published "standard of care" for anesthesiology, then it doesn't exist, and only guidelines are available. But standard of care in the legal realm, has a very different meaning, and is what a prudent person would do in a particular situation. Prudence in the legal sense is defined as "a reasonable standard of judgment , management, and conduct under the circumstances, based on what was known or should have been known at the time a decision was made or the action was completed. Prudence involves a duty of care to others." You don't have a VL in a surgery center and can't intubate with a subsequent hypoxic injury, you are going down, based on the legal definition of standard of care. You are also culpable of failure to give informed consent, if you knew a VL was not available but you decided to move forward with the anesthesia anyway without explaining that you did not have a VL and the options available including canceling the surgery until you could obtain a VL or referral elsewhere.

 

[aneftp]

No, my use is 100% accurate. You believe that unless there is a published "standard of care" for anesthesiology, then it doesn't exist, and only guidelines are available. But standard of care in the legal realm, has a very different meaning, and is what a prudent person would do in a particular situation. Prudence in the legal sense is defined as "a reasonable standard of judgment , management, and conduct under the circumstances, based on what was known or should have been known at the time a decision was made or the action was completed. Prudence involves a duty of care to others." You don't have a VL in a surgery center and can't intubate with a subsequent hypoxic injury, you are going down, based on the legal definition of standard of care. You are also culpable of failure to give informed consent, if you knew a VL was not available but you decided to move forward with the anesthesia anyway without explaining that you did not have a VL and the options available including canceling the surgery until you could obtain a VL or referral elsewhere.

Fine. I give u a 2006 barely usable videscope that’s been serviced recently. No equipment is outdated or end of life as long as parts are available and serviceable (that is true fact)

The center has provided that for you. There your standard. Right?

 

[Aether2000]

Fine. I give u a 2006 barely usable videscope that’s been serviced recently. No equipment is outdated or end of life as long as parts are available and serviceable (that is true fact)

The center has provided that for you. There your standard. Right?

If the VL is substandard and you are aware it is unusable, then it does not meet the standard of care. If you proceed with an anesthetic that results in a disaster because of this VL, then you are just as culpable as the surgery center.

 

[aneftp]

If the VL is substandard and you are aware it is unusable, then it does not meet the standard of care. If you proceed with an anesthetic that results in a disaster because of this VL, then you are just as culpable as the surgery center.

lol. Now you say it’s substandard.

You are going down a slippery slope what is standard and substandard.

This is a 501c non profit hospital that has the 2006 videosocpe available for me. It’s pretty pathetic

But it’s been service and and has that biomed sticker etc.

 

[deleted87051]

lol. Now you say it’s substandard.

You are going down a slippery slope what is standard and substandard.

This is a 501c non profit hospital that has the 2006 videosocpe available for me. It’s pretty pathetic

But it’s been service and and has that biomed sticker etc.

It’s pretty pathetic to accept an assignment at such a pathetic hospital. Are you that desperate or that greedy?

 

[aneftp]

Is this videoscope at my hospital in middle of cs bmi 51 on Thursday night at 1030pm. Does this fit the “standard of care?”

We gone from requiring videscope to requiring better video scopes?

It works. But I have my own McGrath I use.

 

[deleted87051]

Is this videoscope at my hospital in middle of cs bmi 51 on Thursday night at 1030pm. Does this fit the “standard of care?”

We gone from requiring videscope to requiring better video scopes?

It works. But I have my own McGrath I use.

So I wonder what else they don’t have.

 

[Lab Lover]

Never use the word standard of care lightly.

Standard of care is hard ingrained.

There are very few standard of care especially in medicine and anesthesiology (for our speciality)

Most are just guidelines.

Not exactly. There aren't that many ASA "Standards" but "standard of care" is whatever an "expert" can sell.

 

[aneftp]

Not exactly. There aren't that many ASA "Standards" but "standard of care" is whatever an "expert" can sell.

Now you get it. One of the few times we agree

It’s all a game. A show to the lawyers.

Has nothing to do with what’s right or wrong.

It’s for shock show to present to the jury.

Juries are dumb in deciding many cases of malpractice. Gotta love America and court system.

You can do everything right and still get a verdict against you.

 

[Aether2000]

Now you get it. One of the few times we agree

It’s all a game. A show to the lawyers.

Has nothing to do with what’s right or wrong.

It’s for shock show to present to the jury.

Juries are dumb in deciding many cases of malpractice. Gotta love America and court system.

You can do everything right and still get a verdict against you.

And there are times when physician's behaviors and decisions are indeed the cause of complications, and in most cases they get off scot free because the legal system only takes cases that are easy to prove. You can do everything wrong, cause injury or long term complications, yet continue to enjoy practicing medicine unconstrained. Patient Harm: When An Attorney Won’t Take Your Case

 

[aneftp]

And there are times when physician's behaviors and decisions are indeed the cause of complications, and in most cases they get off scot free because the legal system only takes cases that are easy to prove. You can do everything wrong, cause injury or long term complications, yet continue to enjoy practicing medicine unconstrained. Patient Harm: When An Attorney Won’t Take Your Case

Correct. The key word in that article is “potential for economic damage” is low.

So a fully recovered patient even with a malpractice case is less likely to present a good show for an attorney seeking damages.

That’s why attorney wants to see a locked in vegetable patient rather they my 95% recovered vertebral artery dissection from chiropractor I had to tell the ER docs to get the right angiogram the second time. She shopped around and the big law firms won’t take her case.

She had to on blood thinner and still has some balance problems. Was only 38. Now 43. Mother of 2. If she ended up as vegetable it’s a slam dunk case for her. Obviously she wouldn’t be able to enjoy it being a vegetable but the attorney will enjoy his millions.

 

[Blackmateria]

I always thought the McGrath screen was way too dark. I bought an original Glidescope that is unwieldy but get the job done for a grand I think. There are a lot of "luxury surgery centers" in LA that are little more than closets with the cheapest operating table they could buy and a glorified Mapleson circuit. The lobby will have marble finishes though.

 

[cchoukal]

Correct. The key word in that article is “potential for economic damage” is low.

So a fully recovered patient even with a malpractice case is less likely to present a good show for an attorney seeking damages.

That’s why attorney wants to see a locked in vegetable patient rather they my 95% recovered vertebral artery dissection from chiropractor I had to tell the ER docs to get the right angiogram the second time. She shopped around and the big law firms won’t take her case.

She had to on blood thinner and still has some balance problems. Was only 38. Now 43. Mother of 2. If she ended up as vegetable it’s a slam dunk case for her. Obviously she wouldn’t be able to enjoy it being a vegetable but the attorney will enjoy his millions.

One could look at this as an example of the system working. A 95% recovered patient probably shouldn’t get a ton of money. Negligence AND harm.

 

[aneftp]

One could look at this as an example of the system working. A 95% recovered patient probably shouldn’t get a ton of money. Negligence AND harm.

It didn’t work. I’m the one who diagnosed it via FaceTime when she called me from the ED after another negative ct head. Which we all know is the the wrong test to get. That was the second type in 36 hrs she was wrongly diagnosed.

They send her home again. She’s a got bigger issues. Or worse case a vegetable.

Most people have seen that Georgia lock in malpractice case 70 million judgment from chiropractors case. Like wtf. The chiropractor doesn’t get sued. Probably because he/she doesn’t have any money.

“
A jury sided with the man in 2022, awarding $46 million in civil damages and $29 million in medical expenses. About 60% of the sum was pinned on the EM physician, and 40% on the radiologist, while other clinicians were cleared. “

https://www.reddit.com/r/medicine/s/2HiJFNcNGl

 

[Nexus5]

Anyone like glidescope go2?

Are they a lot more than the mcgrath?

 

[NicholasPavona]

Anyone like glidescope go2?

Are they a lot more than the mcgrath?

You know who likes the glidescope go2? Diddy.

 

[Nexus5]

You know who likes the glidescope go2? Diddy.

lubing up styles across state lines