portable video laryngoscopes

Started by mannadoes
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mannadoes

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Just want to get your opinions on which video laryngoscopes you guys would recommend.
Looking for something I could carry in my pocket (which for size means foldable blade, collapsible lcd screen) and rechargeable or battery operated.
Something durable that can take repeated stress and not blip out during the lifts like the older mcgraths, but holds up like the bulkier one piece glide scope.
Seems like there are a lot of manufacturers, as it would be a personal purchase, not by an institution, therefore something I can afford.

I am interested in your opinions.
 
We are trialling the new McGrath Mac. I like it. I have used it for every laryngoscopy for the past two weeks including several predicted difficult laryngoscopies, two double lumen tubes, a woman with mouth opening that only gave me enough space to squeak the blade in (she was also successfully intubated for a second surgery with the Glidescope), and a 8 year old. So far I am very happy with it and would have a hard time choosing between it and the Glidescope if I had to choose one.

The video quality is not as good as the Glidescope, neither is the power of the light, but I have found both to be more than adequate.



It won't fit in your pocket, but it would likely fit in a reasonably sized bag/ briefcase.

What other similar devices are out there?

- pod
 
I am most familiar with the AirTraq, though this is optical and not on an LCD. If you are looking for a LCD then consider the King Vision. Both devices are a recapitulation of the glidescope or Storz D blade and work rather well. Cost is about the same when all is said and done, as I understand it.

Iride
 
We use the Ranger in our airway bag at the VA.

Ranger_ComponentImage_thumb_400_533_c1.png


I think it is essentially identical to the Glidescope but just a small portable rechargable unit. The screen resolution leaves a little to be desired but it has definitely bailed me out in a pinch a time or two as a CA-1 by myself emergently intubating some difficult airways in the middle of the night. Not sure about the cost.
 
Honestley, I never really liked the McGrath cause the screen flickers. I know its bulky and I know it won't fit in your pocket, but the glidescope is the greatest thing invented since sliced bread. Just use the preformed stylet and that tube goes thru the cords everytime. And the screen is nice and big so anatomy is easy to see.
 
You are thinking about the old McGrath with the sliding "blade". The new McGrath Mac was designed to eliminate that issue and it did so quite nicely.

Glidescope has better video and lighting, but do you really need 1080p for this job or will 720p be adequate? (of course the resolution isn't that good, but the difference between the two is pretty similar to the difference between 1080p and 720)


- pod
 
Do we really need all these toys? I don't even remember the last time I used a Glidescope. Maybe about a year ago.

People become addicted to these things.
 
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Sure, I could safely do 99% of my cases with a manual sphygmomanometer, a stethoscope, and an ether (sevo) mask... but then again automated vitals, the anesthesia machine, and endotracheal tubes sure make the whole job a lot more pleasant for everyone involved and fractionally safer. Video laryngoscopes fall into the same category. Unnecessary for 99% of cases, but now that they are becoming ubiquitous and reasonably cheap, I wouldn't lose any sleep if the laryngoscope went the way of the manual sphygmomanometer.

- pod
 
urge said:
Do we really need all these toys? I don't even remember the last time I used a Glidescope. Maybe about a year ago.

People become addicted to these things.
Click to expand...

👍

Not a great analogy pod: automated vitals, the anesthesia machine, and endotracheal tubes free your hands to perform other tasks (sit back and relax) while the video laryngoscope doesn't .
 
So until you can just press a button and have it intubate for you while you are charting, chatting up the nurse etc, it is just a useless toy? Okay.

It is a great analogy if you look at what they do for us, not the mechanism by which they do it.

All of these "toys" are un-necessary for the majority of our cases, but they make our job slightly easier, and potentially safer and less traumatic for the patient. The automatic machines do it by freeing your brain from focusing on repetitive tasks. The endo-tracheal tube by freeing your hands and, in a very small percentage of cases, providing much needed protection for the lungs. Video laryngoscopes do it by allowing us to intubate sub-optimal airways (for whatever reason) with ease even when the difficulties are unexpected.

We get it, you are the Jedi Master of the laryngoscope... You can intubate a gravid fire-ant with a C2 burst fracture with a Miller 1,2,3,or 4 in 2.5 seconds flat without moving her neck 1 mm. You never call for one of those Bougie or a bronchoscope toys either.

Great. We aren't all Jedi Masters and for your colleagues who are not, this toy makes the job easier and potentially safer and less traumatic. Why would you have a problem with that? Simply because it might decrease one's skill with an antiquated tool? What is the goal here, ensuring the survival of an antiquated tool or making the job as easy and safe as possible?

So far the only good defense I have heard for the traditional laryngoscope are the issues of cost and ubiquity both of which are rapidly becoming less significant. Otherwise it is just a lot of macho chest beating about how "I am so good with a laryngoscope that nobody should NEED something easier." Inherent in this pride is the acknowledgement that the skill is somehow unique and something to be proud of, otherwise there is no need to be proud of it. So, consciously or not, you have acknowledged that not everyone is that good. So why disdain the tool that makes their job easier other than to make yourself feel good?

Maybe we should get rid of modern vaporizers too. After all, I can easily provide volatile inhaled with a glass syringe, a bottle of sevo, and a anesthesia circuit. So why should anybody need one of those modern vaporizer toys?

- pod
 
urge said:
Do we really need all these toys? I don't even remember the last time I used a Glidescope. Maybe about a year ago.

People become addicted to these things.
Click to expand...
I'm a surgery resident, but I still like to do the intubation on my patients if I can. There are a few anesthesiologists who will almost always let us do it, if we just ask.

I got to use the McGrath this week, and I thought it made things more complicated. I much prefer the direct look, but as far as the technology goes, it is quite usable. I think the only button was the power button, and the screen size/quality was more than adequate. The image quality on the Glidescope is far better though.
 
Not quite my point but thanks for the rant.

periopdoc said:
We aren't all Jedi Masters and for your colleagues who are not, this toy makes the job easier and potentially safer and less traumatic. Why would you have a problem with that?

- pod
Click to expand...

I don't have a problem with it i just don't think it has a good cost/benefit ratio in my patient population.
 
periopdoc said:
So until you can just press a button and have it intubate for you while you are charting, chatting up the nurse etc, it is just a useless toy? Okay.

It is a great analogy if you look at what they do for us, not the mechanism by which they do it.

All of these "toys" are un-necessary for the majority of our cases, but they make our job slightly easier, and potentially safer and less traumatic for the patient. The automatic machines do it by freeing your brain from focusing on repetitive tasks. The endo-tracheal tube by freeing your hands and, in a very small percentage of cases, providing much needed protection for the lungs. Video laryngoscopes do it by allowing us to intubate sub-optimal airways (for whatever reason) with ease even when the difficulties are unexpected.

We get it, you are the Jedi Master of the laryngoscope... You can intubate a gravid fire-ant with a C2 burst fracture with a Miller 1,2,3,or 4 in 2.5 seconds flat without moving her neck 1 mm. You never call for one of those Bougie or a bronchoscope toys either.

Great. We aren't all Jedi Masters and for your colleagues who are not, this toy makes the job easier and potentially safer and less traumatic. Why would you have a problem with that? Simply because it might decrease one's skill with an antiquated tool? What is the goal here, ensuring the survival of an antiquated tool or making the job as easy and safe as possible?

So far the only good defense I have heard for the traditional laryngoscope are the issues of cost and ubiquity both of which are rapidly becoming less significant. Otherwise it is just a lot of macho chest beating about how "I am so good with a laryngoscope that nobody should NEED something easier." Inherent in this pride is the acknowledgement that the skill is somehow unique and something to be proud of, otherwise there is no need to be proud of it. So, consciously or not, you have acknowledged that not everyone is that good. So why disdain the tool that makes their job easier other than to make yourself feel good?

Maybe we should get rid of modern vaporizers too. After all, I can easily provide volatile inhaled with a glass syringe, a bottle of sevo, and a anesthesia circuit. So why should anybody need one of those modern vaporizer toys?

- pod
Click to expand...

Don't get your panties in a wad. I'm just pointing out that the vendors are creating more difficult "difficult airways" than there really are.

I'm tired of every ten minute someone "inventing" some airway device. it is ridiculous.

I'm also tired of the academic guys making a career out of the difficult airway. Whole textbooks about intubation. Is there really so much to know so called "airway experts"? Just shove the tube in. No fanfare.

To top it off now there is some international airway society going around charging gazillions for courses, and advancing couple of guys careers Futaba, or something similar to the rc car remote control company, it is called. Just another scam to sell more difficult airway BS.
 
The inventor of the JED is the same guy that invented the proneview, so yes he's doing quite well financially. He also happens to be my clinical advisor and is one one of the most knowledgeable, experienced, and clinicall skilled faculty we have here. Apparently places that do a lot of eyeballs and other local/MAC's are buying a lot of these things. That being said, I've never felt the need to try it out myself.
 
I am still amazed at the gasps and sighs I get in the ICU or PACU when a single finger extending the mandible relieves airway obstruction. Of course, I don't want to stand there all day, so if I'm lucky a simple head turn solves the problem.
 
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I hated the old McGraths for their shoddy craftsmanship, the new ones have shown no signs of fatigue (3 months experience). One of the original type crapped out after a month. While it technically fits in my pocket (mostly), I would not trust it there because it is just a little to big, heavy enough to be a major drag on the pants, and a pretty expensive thing for me to sit on. It would easily fit in a fanny pack sized bag.
Views provided and angles of blade are very similar to glidescope if you have used that.
It is the smallest video scope I personally have used.
 
I've taken a look a most of the devices listed. On the ambulance we stocked the airtraqs in the difficult airway bag. They are pretty reliable and very small...they meet the requirement of fitting in your pocket, however there are some downsides- once you turn it on you need to wait a few seconds for the defog feature to work properly. Also- when looking in the viewing window, you need to get awfully close to the patients face which I really don't like. Its a good option but given the choice between that and the glidescope ranger there is really no comparison (as long as you can accept it won't go in your pocket).
 
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