Glide vs C-Mac

[DocVapor]

My place only has Glidescopes, but as a med student I had the opportunity to use a C-Mac a small handful of times (on a MICU rotation). I'm perfectly comfortable with the glidescope and am not sure I'm really missing out by not having a C-Mac available to practice with. Thus my questions:

Which one do you prefer, if either? If you have access to both, are there times where you might reach for one versus the other, and why?

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[IMGASMD]

Don’t matter. Just need to get use to what you’re comfortable with. I like McGrath personally, because I was trained with it. I used to have access to McGrath and Glide. We covered all urgent airway in the hospital, it’s much easier to have a McGrath in my pocket than logging Glide around.
Just be comfortable with what your facilities have.

 

[CopaceticOne]

We mostly have CMACs, Glidescopes, and King Visions (I forget what we have at our children's hospital). For really anterior airways I seem to like the CMAC D-blade best. For smaller mouth openings I prefer the newer Glidescopes. For teaching med students/interns, I love having them use the handheld CMAC with a MAC 3 blade and the screen only pointed so I can see it while they must use it as a DL.

 

[deleted171991]

My place only has Glidescopes, but as a med student I had the opportunity to use a C-Mac a small handful of times (on a MICU rotation). I'm perfectly comfortable with the glidescope and am not sure I'm really missing out by not having a C-Mac available to practice with. Thus my questions:

Which one do you prefer, if either? If you have access to both, are there times where you might reach for one versus the other, and why?

Both are great, way above the McCrapGrath. The C-Mac has a D-blade with has the same type of angle as the glidescope. The value of the C-Mac is that it has a version that allows attaching all kinds of extensions (e.g. fiberoptic) and can save the videos.

 

[Aether2000]

C-Mac has two models with C-Mac (metal blade, sterilizable) and C-Mac-S (plastic blade). C-Mac also comes with several monitor options: PM (attached to C-Mac), C-Mac video monitor, and C-Hub for displaying on other OR monitors. Glidescope is available with the original disposable metal blade (thin contour) and Glidescope Go with the monitor attached to the handle. We prefer the C-Mac metal blade>Glidescope>>C-Mac-S. The base of the C-Mac-S blade is so thick that you need a crow bar to pry the mouth open enough to get the blade deep enough to intubate on some patients. We recently trialled the Glidescope Go, and it is very impressive. Have used the Kingscope and McGrath but the visualization was not as good for me (dimmer, optics not as clear). The expense is also an issue since these units can cost up to $13,000.

 

[shepardsun]

Cmac and McGrath are both nice in that they can be used as direct laryngoscopes- when I was a CA-1 and working on tougher airways I would try to do what I could with the DL functionality and switch to the screen if I needed a little extra help. Now I use them with newer residents to help them learn the basic anatomy. Much easier to help guide someone when you can see what they are seeing.

 

[thinkorswim]

Both are great, way above the McCrapGrath.

I don’t mind using any of the three, but I actually kind of like the smaller profile of the McGrath blade where it can be especially useful in patients with smaller mouth openings.

 

[ProtonPump]

The value of the C-Mac is that it has a version that allows attaching all kinds of extensions (e.g. fiberoptic) and can save the videos.

The (modern) glidescope screen has a USB slot and can and does record video if you want.

 

[Robotic Wis-Hipple]

The Glide-o-scope is the better tool imo but the C-Mac is fine too. The McGrath is pretty weak imo for true bad anterior airways.

Our code bag has this bad boy in it:

GlideScope - Portable Video Laryngoscope by Verathon

 

[vector2]

Glide-uh scope > cmac d-blade >>>> McGrath. Mcgrath is fine as a teaching tool but without the hyper angulated X-blade it's pretty useless for difficult airways. Also in general the metal blade versions of glide and cmac are far superior to the plastic ones.

 

[Southpaw]

We trialed the CMAC with fiber optic ability. Seemed very nice and was my favorite. Was too rich for my hospital system though - we ended up Glidescope which is fine.

 

[AdmiralChz]

We trialed the CMAC with fiber optic ability. Seemed very nice and was my favorite. Was too rich for my hospital system though - we ended up Glidescope which is fine.

An expensive but great system with good optics. The interchangeable FOB and laryngoscope is an awesome and very portable feature.

What they don’t tell you is the FOBs are very fragile and frequently break - they make even more dough from fixing them. It’s a bit of a racket, so their overall market penetrance has fallen a bit as people have gotten wise to this. We recently got rid of ours here for this reason - a joint committee here with the hospital estimated we could cut our costs by over half by using the disposable AMBU FOBs. Those aren’t the best quality but the price is more palatable - for big time bronch/BALs we use a formal tower now.

 

[DM27]

We have both where I am. I prefer the glidescope, but I will say one plus about the CMAC is I find it is less finicky about the stylette angle, allowing normal stylettes to be used, compared to the glidescope.

 

[koan]

A nice alternative to the McGrath for handheld/portable is the UE Scope. Super clear, bright view. Agree that the Glide-uh stylet is annoying (and potentially dangerous — case reports of perforated soft palates and tonsillar pillars due to its unyielding rigidity)

 

[rakotomazoto]

They all have their quirks and advantages. It is best to get some hands-on experience with all of them while in training if possible. I had never used the McGrath until post-residency and I probably looked like a fool since the first time I used it, the patient was quite anterior and had to switch to glidescope to get a view. In hindsight, poor patient selection to try something new on my part, even though I had asked a couple of partners the night before what they would do in that situation and they both said McGrath is where it's at. Despite that first fumble, the McGrath has worked well every other time I have used it. That was a particularly strange airway with redundant soft tissue folds, etc.

Point is, I might have made a different management decision if I was more familiar with the McGrath. My partners told me it was "the same or better" than glidescope; however, in this anterior airway, that was clearly not the case.

The other airway surprise has been using fiberoptic scopes with only an eyepiece, something I had done a couple of times just for kicks, but hadn't needed to rely on during residency, where we connected to the big screen so the entire OR could appreciate our airway management skills, or lack thereof. Getting comfortable with doing things many ways is always wise.

 

[propadope]

Glide-uh scope > cmac d-blade >>>> McGrath. Mcgrath is fine as a teaching tool but without the hyper angulated X-blade it's pretty useless for difficult airways. Also in general the metal blade versions of glide and cmac are far superior to the plastic ones.

Anyone have experience with the X-blade? I have only used the MAC blades with the McGrath.