Do you already own a video laryngoscope or want to buy one? Our experienced anaesthesia experts are happy to explain the correct handling of a video laryngoscope. Although many colleagues might think that video laryngoscopes are self-explanatory, there are some pitfalls that need to be considered. We have summarized 5 important points that you need to consider when using a video laryngoscope.
Here are 5 expert tips you need to know
#1 Failure is possible despite modern technology
Time and again we hear that thanks to video laryngoscopy “every” patient can now be safely intubated. If that were the case, anesthesiologists would be virtually no longer needed and no patient would be able to die from the difficult airway. Therefore, please remember the following sentence: Even a video laryngoscope can unfortunately not solve every respiratory problem!
Although the video laryngoscope has become a fixed place in the respiratory algorithm, it is “only” one of many possibilities that should not be unused in an e.g. “cannot ventilate, cannot intubate” situation. A tonsil after-bleeding, for example, is still a major problem for video laryngoscopes, because as soon as you dive into the throat with the camera in the “blood lake”, you will no longer be able to detect any anatomical structures. Even modern video laryngoscopes such as the MAC video laryngoscope McGrath cannot solve this problem. In this case, you have to suck the blood or secretion and, with good luck and skill, possibly even intubate fiber optic.
#2 Light sunlight can become a problem
If you’ve ever had to intubate someone at the glacier at 3000m in the best weather, then you know where we’re talking about. It is so bright that it is almost impossible to detect any anatomical structures even on the brightest LED display in the world. You absolutely have to get creative here and provide darkness around the patient’s head through scarves and jackets. However, if you do not have helping hands, it will be almost impossible to deal with this situation on your own. In this case, you will always have to prefer a classic laryngoscope to the video laryngoscope.
#3 Single-time video laryngoscope vs. Reusable Video laryngoscope
Which video laryngoscope is the best? We are often asked that. The honest answer is: there are many good video laryngoscopes,but you can’t really say which is “the best”. There are many advantages and disadvantages for each manufacturer that you have to weigh up personally. We have summarized the most important points for you:
There are many manufacturers that produce one-time video laryngoscopes. The most prominent representative of recent years was the Airtraq. One of the first video laryngoscopes to be purchased. This one-time video laryngoscope has always served well, but has been replaced in many clinics by more modern developments. The advantage of a one-time video laryngoscope is obvious: it is cheap, offers good value for money and provides good services.
Reusable video laryngoscopes have mostly integrated very high-quality camera systems and deliver excellent images. Unfortunately, these devices are more expensive to purchase than one-time video laryngoscopes and need to be sterilized after use. This not only costs, but also the potentially life-saving device can no longer be accessed in time.
Today, the industry offers us many “mixed variants” between single-use video laryngoscopes and reusable video laryngoscopes. For example, the MCGrath video laryngoscope is a good example where the reusability and the “disposable system” have been linked together: for example, the MCGrath video laryngoscope has a very high-quality camera, a super-bright large LED display and a long-lasting battery. These components can be reused for hundreds of applications. The spatulas or components that have been in contact with the patient are disposable products that can be removed and discarded after each application. Also the fact that there are several special spatula and different attachments for the MAC video laryngoscope McGrath increases the flexibility and makes intubation often possible even under difficult conditions.
#4 Integrated Display vs. External Monitor
However, you still have to ask yourself a question before purchasing: would you rather have an external monitor, i.e. You hold the video laryngoscope in your hands while you get a camera image transferred on a large external monitor. Or would you rather hold the video laryngoscope in your hands and look directly at an LED display? This is much smaller than external monitors, but you don’t have to turn your head away and can intubate classically as before and always have everything in view:
Integrated display e.g. for the MAC video laryngoscope McGrath:
External monitor e.g. at ambu Ascope:
#5 How much does a video laryngoscope cost?
How much does a car cost? 🙂 Exactly – anything is possible. Even for experienced buyers, it is always a challenge to calculate correctly. Moreover, price is not everything. Longevity is at least as important as good support. It is obvious that the market offers expensive video laryngoscopes as well as cheap no-name products. Please be careful when choosing your suitable product. We would be happy to advise you by phone or email, if you are inconclusive here. Meinarztbedarf.com now offers a variety of video laryngoscopes for you including optional training by proven experts.
The following is a sample calculation for the MAC video laryngoscope McGrath:
- Purchase of equipment from 1629 euros net per piece
- Replacement battery (250 minutes of use) 49 Euro per piece
- Spatula attachments size 1-4 each in the 50 pack 9.90 Euro net
An intubation comes to 9.90 euros cost for the one-time spatula. Considering that it takes 3 minutes for intubation and can intubate about 80 times with a battery, the battery costs just 0.6 euros per intubation. After 1000 intubations, the MAC video laryngoscope McGrath comes to just 1.6 euros per intubation. Added up (1.6 + 9.9 + 0.6 = 12.10 Euro) an intubation with the MAC video laryngoscope McGrath comes to approx. 12 Euros in the long term. However, if one now considers that by using a video laryngoscope you can reduce intubation-late complications and also demonstrably minimize the risk of contagion, then the price is absolutely justified. Many clinics, emergency services and emergency physicians have recognized this fact and have been enjoying their own video laryngoscope for years, which can also create psychological safety and well-being for doctors who rarely have to intubate.