You read that right! Dr. Jeff Jarvis is a medical director who only uses video laryngoscopy (VL) for the EMS agencies he acts as a medical director. Not only that, but in his own practice in emergency medicine, he uses a VL system.
What is so great with VL that they ditched traditional direct laryngoscopy? Well for that, you will need to listen to the show. However, there are some key points discussed that we wanted to include in our show notes for our readers.
In the podcast we talked about the difference between VL and DL. Some of you may not fully understand the difference. The first step is to understand the two main forms of DL. There are MacIntosh and Miller blades with the former being curved and the latter straight. The main difference between the two is that the curved MacIntosh has its tip placed in the vallecula whereas the Miller blade lifts the epiglottis directly as seen in the image.
When performing intubation, one of the key steps is to visualize the epiglottis. This is discussed by the famous Dr. Rich Levitan on EMCrit in detail. Some VL and DL are similar with being able to see the cords directly. However, one famous example of a hyper-angulated blade that does not allow for direct visualization and relies solely on the video feed is the GlideScope (but there are others out there that are similar. There has long been controversy to such blades but one other example for which Jeff Jarvis and his EMS agencies use is the King Vision device.
This podcast is not designed to tell you which one is better and the jury is still out. However, in this podcast we review a case where EMS has almost in every occasion switched to VL. They technically still care a back-up but can only be used for foreign bodies. Even then, it has only been used once and that is discussed in the podcast (find out more details there). Keep in mind, with our recent podcasts, Jim DuCanto discussed SALAD which can be used with both VL and DL.
Both us and our guest are happy to discuss these points in more detail. A second podcast which will cover some other facets of VL will be out next so come back next week. In the meantime, if you have questions you can leave them here, contact Jeff Jarvis or us on Twitter, contact us on Facebook, or email us directly. We hope that you stick with more public options so that others may seem them as well. We thank you for listening and ask that you leave us a positive review especially oniTunes as every 5 star rating and positive review helps us. Until next time, continue to provide total care everywhere.