GlideScope vs. McGrath Laryngoscope?

[soorg]

About to get one or the other...

Which is better, in your experiences?

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[Hernandez]

About to get one or the other...

Which is better, in your experiences?

From a pulm-cc fellow. Both are nice and work well and both have the hyperacute angle on the lens. The icu I finished my IM residency had the mcgrath and to me it's a little more buggy than the glidescope. Prior to use you must place anti-fog drops and then after use you need to clean all of the contacts as you will develop a flickering-green screen which sucks when you just loose visulization with the tube in the mouth. The mcgrath rep failedto supply us with that info so we damn near got rid of it until they toured out what we were doin wrong. The goods over the glidescope is the mcgrath has built in adjustment instead of having to use different handles and your not going to loose the various size handles. If it were my icu. I'd get probably get the glidescope.N please ignore the smart phone spelling errors.

 

[oldguy55]

We have one of each. I like the GlideScope for the larger screen. For those of us with "mature" eyes it is much easier to see what you are doing. With the McGrath you must manipulate the 'scope a bit more to get the right viewing angle.

OTOH, the McGrath is nice to take along for an urgent intubation in the ICU, etc.

 

[sevoflurane]

We have them both. I did research on the glidescope. The glidescope is a better tool but not as portable as the Mcgrath. Slightly easier to use. Both are excellent tools (A++), but I give higher marks to the glidescope because:

1) Screen size
2) Better views (miniscule difference)
3) No need to change battery

Portability of Mcgrath is far, superior. It is small and is much harder to break/repair. I would buy it for an ASC. If you are at a hospital with lots of BMI's>40 I'd go for the Glidescope. We had 3 Mcgraths before I convinced our team to get a Glidescope. Now the glidescope is the tool most frequently asked for when needed.

BTW: If you get the Mcgrath, train your techs to replace the battery EVERY TIME it is used.

 

[cchoukal]

The portability of the McGrath is a potential liability. If you're in a large practice with multiple sites, the McGrath will disappear in weeks. The Glidescope can be mounted on a little trolley or stand or whatever, making it harder to walk off with. Anecdotally, I find the Glide easier to use as well. You could probably price out the difference between equipment/processes to sterilize the Glide versus the disposable blade/covers for the McGrath and maybe that would tip you one way or the other.

 

[sevoflurane]

The portability of the McGrath is a potential liability.

Very True. We had a locums walk out with one of ours. 😡😡......

The glidescope will breakdown before the Mcgrath.

 

[starsop93]

Anyone use the Storz version?

I have recently read a couple of studies (probably heavily funded by the Storz people) which claim the highest success rate with it vs the McGrath (what we have) and the Glidescope. I've never used it, and it looks a lot like the glidescope online.

 

[Hernandez]

Anyone use the Storz version?

I have recently read a couple of studies (probably heavily funded by the Storz people) which claim the highest success rate with it vs the McGrath (what we have) and the Glidescope. I've never used it, and it looks a lot like the glidescope online.

I Used it at the difficult airway course and personally thought the handle was too wide and I'm not a tiny guy. The one other tool they demo'd at tdac was the airtraq system but for a anes practise I don't think that would be very cost effective since it's disposable.

 

[pjl]

We have both at our training institution. The McGrath is only good for its portability, otherwise the Glidescope wins hands down in my opinion. If you need portability more than functionality, let that be your guide. In any case I recommend using the same bend of the stylet as the glidescope for either scope. Once you get used to it (>10 intubations) it will be VERY rare to find an airway you can't get with either one. We are actually concerned with the drop in fiberoptic experience.
Here are my reasons:
Reasons for the Glidescope
1. Manufacturing.
-Within 3 months of HEAVY use one of the McGraths now has a screen that flickers and does not work if you lift out and up (the direction you lift for intubating) which makes it almost completely worthless. Seems to be a bad connection. Now further along I am seeing this problem with a few of the other scopes.
-The sliding blade for different lengths looosens up over time, making it slide during intubations. This has been an issue on many of the scopes.
2. Screen visibility. Glidescope has a bigger screen, which is nice, depending on your situation (teaching vs personal use)
3. Versitility. Peds option for glidescope.

Reason for McGrath:
1. Portability. I can carry it with me up stairs, over obstacles in rooms, anywhere. Potential neg as posted above, so can someone else, and there goes 8 grand out the door.

PS. If you use the lithium batteries for the McGrath they last for multiple intubations. Also your pager battery will work in the McGrath, so if you throw one of those in your pager it will last like 6 months and always have plenty of charge for the scope.

 

[lushmd]

The issue with the Storz is that, unlike the Glidescope, it doesn't provide any more of an anterior view than a traditional laryngoscope. I would opt for the Glidescope (preferably) or McGrath over the Storz.

 

[Jay K]

Glidescope for everything mentioned above.

Also, it's easier for your hospital to have a cache of blades so you'll always have the Glidescope available after immediate use, vs having to "clean" the McGrath. You can have sets of blades "cooking" in the steris while you have more spares for multiple intubations throughout the day cycling in/out. The J-stylet used by the Glidescope is also handy, despite one being able to manufacture your own w/ a standard stylet. I'm not certain that exists w/ the McGrath.

 

[omegaman]

We had three McGraths and after a few months of use they all have “a screen that flickers and does not work if you lift out and up (the direction you lift for intubating) which makes it almost completely worthless.”

Even when the McGraths is working 100% the image is far worse than the image on the glidscope. If portability is an issue glidscope makes a battery powered portable version.

We have both at our training institution. The McGrath is only good for its portability, otherwise the Glidescope wins hands down in my opinion. If you need portability more than functionality, let that be your guide. In any case I recommend using the same bend of the stylet as the glidescope for either scope. Once you get used to it (>10 intubations) it will be VERY rare to find an airway you can't get with either one. We are actually concerned with the drop in fiberoptic experience.
Here are my reasons:
Reasons for the Glidescope
1. Manufacturing.
-Within 3 months of HEAVY use one of the McGraths now has a screen that flickers and does not work if you lift out and up (the direction you lift for intubating) which makes it almost completely worthless. Seems to be a bad connection. Now further along I am seeing this problem with a few of the other scopes.
-The sliding blade for different lengths looosens up over time, making it slide during intubations. This has been an issue on many of the scopes.
2. Screen visibility. Glidescope has a bigger screen, which is nice, depending on your situation (teaching vs personal use)
3. Versitility. Peds option for glidescope.

Reason for McGrath:
1. Portability. I can carry it with me up stairs, over obstacles in rooms, anywhere. Potential neg as posted above, so can someone else, and there goes 8 grand out the door.

PS. If you use the lithium batteries for the McGrath they last for multiple intubations. Also your pager battery will work in the McGrath, so if you throw one of those in your pager it will last like 6 months and always have plenty of charge for the scope.

 

[starsop93]

We had three McGraths and after a few months of use they all have “a screen that flickers and does not work if you lift out and up (the direction you lift for intubating) which makes it almost completely worthless.”

Even when the McGraths is working 100% the image is far worse than the image on the glidscope. If portability is an issue glidscope makes a battery powered portable version.

Have had all the same problems with the McGrath here as well. Not very robust.

 

[dhb]

Glidescope 8 grand , bougie 8 bucks
I don't see the need for these expensive gadgets

 

[aneftp]

Glidescope 8 grand , bougie 8 bucks
I don't see the need for these expensive gadgets

Got that right!

I always carry a bougie in my bag. It has never failed me.

I'm a gadget guy. Glidescope is an excellent device.

But we need to teach residents the basics in backup airway management first. I've seen far many people become too reliant on the Glidescope. My old hospital had 3 of these. One was out for repairs, 2 were in use, and someone needed/wanted it in another OR because of an emergency. Guess what? What do you not when that Glidescope is not available?

 

[lane]

Glidescope 8 grand , bougie 8 bucks
I don't see the need for these expensive gadgets

hopefully i won't either when i get out of a trauma center where emergent intubations on c-spine fxs is a common occurrence

 

[goosegas]

Glidescope 8 grand , bougie 8 bucks
I don't see the need for these expensive gadgets

They are needed because:
-The failure rates and complications associated with DL are well documented in the literature.
-VL's ability to provide a superior view is well documented in the literature.
-VL is much more gentle. Less stress is exerted on the patient during intubation.
-You cannot accurately predict when laryngoscopy will be difficult. VL takes the guess work out of airway management.
-Respiratory related incidents account for the single largest class of events leading to brain damage or death in anesthesia.(ASA Closed Claims).


I think the Glidescope is a good product. Provides an excellent view. Too bad they cost so much. A reusable system with all the blades can run $24K. The McGrath looks cool but I think it is a failed design. They tried to get away with a single blade size. That sounds great but a problem occurs when you ratchet the blade out to a longer length. The disposable sheath no longer covers the entire length of the blade and it gets all goobered up. Their new version that can be placed in the Steris to clean it when that happens costs $15K. I do not feel that it provides as good of a view as the glidescope.

 

[urge]

The issue with the Storz is that, unlike the Glidescope, it doesn't provide any more of an anterior view than a traditional laryngoscope.

Tru dat.

The Storz is a good ol' mac with a camera. Comes handy to train new residents since you can see what they see, but it doesn't help for difficult ones.

 

[dhb]

-VL is much more gentle. Less stress is exerted on the patient during intubation.

🙄