The Light Wand

[jetproppilot]

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Mil mentioned using it for a difficult intubation in another thread.....we had one of our CRNAs move to where Mil is and she's now working for him....says she loves it too....

How many of you use it?

Mil, are you pretty good with it, like its a first-line go to tool?

Did you practice alot on easy cases? How long did it take to feel comfortable with it?

 

[dfk]

i've used it four times.
successful once.
used it on class 1/2 patients.
not easy right off the bat.
for me anyway.
also not good to use if you're learning,
while dikkswinging surgeon is waiting, watching, mumbling...

 

[militarymd]

It's my first go to a/w device if I have ANY trouble at all intubating....and on some airways, I won't even bother with the laryngoscope.

Reasons I like it:

1) CRAZY FAST....a few of our high volume surgeons LOVE the way I can walk into the failed a/w situation with my little magic wand and allow the case to proceed within seconds of turning off the room lights

2) E-Z to cart around....it's only a stylet afterall

3) a blind technique (sort of)....it doesn't matter how bloody or full the vomit or whatever else that can obscure the airway is...it still works

When they aren't so good:

1) REALLY thick necks...or when there is no neck at all
2) when you can't get the room dark
3) when the patient soooo BLACK that the light won't shine through

After my residency, I spent 6 months (in GITMO) where I didn't even pick up a laryngoscope once.....honing my skills with the light wand.

I would say you get pretty good at it after 10+ attempts with someone instructing you.

 

[Gern Blansten]

It is my first "go to" device as well. I agree with Mil on the people it does not work for. It only took about 10 patients for me to get fairly good at it.

 

[Arch Guillotti]

Agree w/MMD's pointers.

I used the light wand sometimes during residency. A few attendings were excellent w/it but a lot of them really weren't that facile (I guess because they weren't trained w/it or whatever). I got OK w/it, probably about 25 or so if I had to hazard a guess. The learning curve seemed a little steep (maybe I just sucked at it). It is an AWESOME rescue device.

I can remember 2 situations where it was absolutely money. The first was the usual stat airway call for an ICU pt. that some poor sap from surgery had induced, taken a few pokes at the airway w/out success and managed to bloody up the airway in short order. The resident I was with slapped that thing in so fast I am sure that noone there that was watching the fasco in progress had any idea that he had just totally dominated an airway.

The second was when I was a CA-1 on another floor call w/the upper level. Guy had a seriously broken neck that was unstable and was in cervical traction with the weight thingy hanging off the back of the bed. Unfortunately for this poor sucker he was in the midst of a big MI and was rapidly going into respiratory failure. We gave etomidate and looked w/the fiberscope but no dice. So lights went out and once again the light wand got slapped in w/out further ado. Once again no one really knew what we did or why in the hell we turned the lights out.

One tip I learned was that sometimes you can be fooled as to its placement if someone is really thin w/out any extra tissue in their neck.

 

[mille125]

It's my first go to a/w device if I have ANY trouble at all intubating....and on some airways, I won't even bother with the laryngoscope.

Reasons I like it:

1) CRAZY FAST....a few of our high volume surgeons LOVE the way I can walk into the failed a/w situation with my little magic wand and allow the case to proceed within seconds of turning off the room lights

2) E-Z to cart around....it's only a stylet afterall

3) a blind technique (sort of)....it doesn't matter how bloody or full the vomit or whatever else that can obscure the airway is...it still works

When they aren't so good:

1) REALLY thick necks...or when there is no neck at all
2) when you can't get the room dark
3) when the patient soooo BLACK that the light won't shine through

After my residency, I spent 6 months (in GITMO) where I didn't even pick up a laryngoscope once.....honing my skills with the light wand.

I would say you get pretty good at it after 10+ attempts with someone instructing you.

politically correct as always

 

[Noyac]

I tried it a few times in residency and I wasn't pleased. Well, anytime I don't get the hang of something after a few tries I seem to turn my head. I'm sure its just me but I like the bougie much much better. I'll try the light thingy tomorrow but I'm not sure we even have one. I'll post my experience. Shouldn't have too much trouble with people being too "Black" up here. Sorry mille, "Colored".


PS: Isn't white a color? If so wouldn't that make me "Colored"?

 

[dfk]

I tried it a few times in residency and I wasn't pleased. Well, anytime I don't get the hang of something after a few tries I seem to turn my head. I'm sure its just me but I like the bougie much much better. I'll try the light thingy tomorrow but I'm not sure we even have one. I'll post my experience. Shouldn't have too much trouble with people being too "Black" up here. Sorry mille, "Colored".


PS: Isn't white a color? If so wouldn't that make me "Colored"?

not even white.
more like a pinkish-tannish-orangeish...
so yea, caucasians ARE colored,
just like every other person on earth.

good point noyac!

 

[OB1🤙]

Where I did my student rotations, they used the wand sometimes, and I thought that in deft hands, it was the greatest invention since the espresso machine. I couldn't wait to learn how to use it. I tried it once as a student, but in my amateur hands, I may as well have been trying to blindly pass a Maglite flashlight into the trachea.

Come to find out that my program for some reason frowns on it (probably cuz nobody has ever used it) and doesn't even keep one lying around, and I was all but ridiculed once for bringing it up as an option during an emergency airway discussion.

So your mileage may vary. I think it's a nice tool to have in your bag of tricks, and when you bust it out and rescue a tough airway with this magic wand with the room lights set to "ambiance" and the neck all a-glowin', it can make you look like Captain Awesome (unless the people around you are too stunned by your stupendousness to realize what you just accomplished, as in the above examples).

 

[Pooh & Annie]

Damn, I think I had seen the word "deft" used maybe once or twice in my life until I got into these forums! Probably a better written than spoken word as I could see some serious confusion based on misunderstandings (ie. "Chip is a deft music critic").

Anyway, I've heard that among people that know how to use it, the light wand is THE BEST rescue device available. I need to find someone at my institution who's good at it so I can get some skills.

 

[Noyac]

I think it is more impressive to walk into a difficult intubation, grab your favorite MAC4 and stick the tube in after much struggling by those involved. The folks in the room seem to say, "who was that masked man"? Well that was DR. Noyac. If you can't intubate using the same method they tried then you haven't lost any ground. Now grab your lighty thingy if necessary. Obviously, this approach is for show offs.

Seemed to happen quite often in my past practice. Not so much currently. Damn these guys are good.

 

[mille125]

I tried it a few times in residency and I wasn't pleased. Well, anytime I don't get the hang of something after a few tries I seem to turn my head. I'm sure its just me but I like the bougie much much better. I'll try the light thingy tomorrow but I'm not sure we even have one. I'll post my experience. Shouldn't have too much trouble with people being too "Black" up here. Sorry mille, "Colored".


PS: Isn't white a color? If so wouldn't that make me "Colored"?

you are right...it is illogical...i wonder who actually invented and applied the term..must have been a fool..it reminds me of a quote from Star Wars , "who is more foolish..the fool or the one who follows him"

 

[urge]

PS: Isn't white a color? If so wouldn't that make me "Colored"?

My art professor in college used to say that white isn't a color. Neither is black. They were "values".

I agree with Noy. If someone is strugling and you intubate with the light wand, then it wasn't you. It was the light wand.

As for rescue devices, some of us don't need any rescue.



















Just kidding. Honestly, I tried to like the light wand but it wasn't for me.

 

[Planktonmd]

I don't like blind procedures especially when they are done in the dark.

 

[mille125]

I don't like blind procedure especially when they are done in the dark.

not my cup of tea either but i will say the people who have experience with it seem to be very very good

 

[militarymd]

I attended a session at the SCCM's difficult a/w workshop/seminar.

The speaker was actually an anesthesiologist, but not an intensivist.

He was FOCUSED on the bronchoscope....clearly because that's what they used at their program.

I brought up/asked his opinion about the "lighted stylet"....he pretty much said it was a useless device...something about wouldn't wasting his time on something like it when "you have a bronchoscope available".

He clearly has never seen one used.....oh well....different departments/practices.

I'll use a bronchoscope if necessary, but sometimes you just don't need all that expensive gear when a 30 dollar stylet will do.

 

[TheSandMan]

Damn, for some reason I have been assigned med students almost every day lately. Being my last year and all, I would love to be honing my skills with stuff like this 😎 The first solid week I get w/o a med student will be a light wand only/predominantly week for me.

PS: what kind of bike do you have mil?

 

[militarymd]

Damn, for some reason I have been assigned med students almost every day lately. Being my last year and all, I would love to be honing my skills with stuff like this 😎 The first solid week I get w/o a med student will be a light wand only/predominantly week for me.

PS: what kind of bike do you have mil?

I like your avatar.

I'm riding my K1200S in mine...and also in my profile pic.

 

[TheSandMan]

I like your avatar.

I'm riding my K1200S in mine...and also in my profile pic.

Damn mil, those are sweet bikes. One day soon when I'm making attending level cash😀