Fiberoptic vs. DL

[OldManDave]

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Glidescope is the bomb, not perfect, but sure beats holding that eye piece and wiggling around with all that equiptment. Just slide in, look at the screen(100X visualization compared to looking through eye-piece) and slide ETT or boogie into the trachea. It is better technology.

I LOVE the glide scope! Have used a number of times on known/suspect unstable c-spines & it works like a charm!!! It also has saved my bacon a couple of times on the classic "Oh $hit! I can see anything!" situation.

 

[OldManDave]

Your LMA and the ol' bougie can bail your ass outta almost any situation except for a subglottic disaster.

I would like to have a GlideScope here or a C-Trach. Never used, let alone seen a bullard in real life. Be nice to get my hands on that bad boy.

We have a light wand but I havent used it.

We also have that Sheckani (spelling) optical wand. That thing is solid man.


Alas, I am just young grasshoppa though.

AMEN to the LMA & the bougie! The bougie has saved my @$$ many times during codes where you are the Lone Ranger of airways - where no one but you knows diddly about A/W management & no one even knows enough to even throw you a bone.

I am not fond of the c-trach - it is too cumbersome in my hands. But, now that I have forced myself to use the lightwand until I feel comfy with it, I am now pretty fond of it. Of course, requiring a dim room limits its utility out of the ORs, in my opinion. I was liking the Bullard & getting fairly adept at them until the glidescope came along...now, I rarely even drag the Bullard out.

 

[Planktonmd]

I really like the glidescope! I have used it for people that can't open their mouth that wide, or can't crank back their neck at all. I also have had good luck with the fasttrack LMA with some people that are easy to mask but for some reason turn out to be Grade 4+.

Anyways, I do have a question for my private practice folks here... In residency, we did plenty of awake FOI. I felt pretty good about them. But after a year in private practice - I have done none. It just doesn't come up. I have had about ten difficult intubations, but they were all easy ventilations so I have used glidescope and fasttrack and one asleep FIO to get the airway. My concern is that my skills will become rusty. And I can't justify doing awake FOI for practice in private practice because of time constraints and patient comfort.

How do you guys keep your skills sharp?

Anyone with previous history of difficult intubation or currently have unstable neck gets Awake fiberoptic intubation, the surgeons don't object because it's not open for discussion.
This is how you keep your skills.

 

[epidural man]

Earlier in the post, we were discussing the airway exam and certain predictors.

Did anybody see this article? I found it pretty interesting. They looked at the submandibular angle.

Suzuki N. Isono S. Ishikawa T. Kitamura Y. Takai Y. Nishino T. Submandible angle in nonobese patients with difficult tracheal intubation. Anesthesiology. 106(5):916-23, 2007 May

Thoughts? Experience with this part of the exam?