1 - you make way too many assumptions about my quality of care, my practice during intubation and the practice of colleagues similar to me with whom I practice. You assume that I am inept even at recognizing when what I am doing is ineffective or dangerous. Someone in such a position should be not be allowed to intubate. I consider myself to be an expert in the emergency airway as I was trained to do so. Your assumption to the contrary is not based in fact. That means I recognize when what am I doing, or when others who are manipulating the airway are doing are ineffective or dangerous. I expect no less with anyone that I practice alongside.
2 - cricoid pressure is highly debatable (
http://rebelem.com/cricoid-pressure-in-airway-management-the-iris-trial/) and that you think it's an example of me not knowing what I am doing makes me think, instead, that this part of your practice is based on myth and dogma. Agree to disagree but I certainly don't think using or not using cricoid pressure is the example you should choose to show EM's ineptitude at managing airways in the ED.
3-Re VL vs DL: No it doesn't - not significantly, and I cannot think of an occasion where an extra 10 seconds made any difference. It takes me literally a few seconds seconds to get glidescope stuff together. It takes virtually the same amount of time to open up the airway box, load a blade and open up an ETT. As pointed out above, your workflow and mine are not the same.
4 - I am plenty comfortable with DL. See my post above about the superiority of VL over DL (
studies primarily taken from the OR where YOUR colleagues are performing the intubation)
My professional society does not recommend IV lidocaine for the massive head injury patient. If you want to use it, its fine there hasn't been any harm shown, but I certainly don't think there's enough data to show not to use it is deviation from care. I do the things that work and the things that are standard of care for now even if they probably don't (i.e. c-collar).
