I have not blogged in a long time. I wasn’t really free to do so in my most recent position. But as the wise sage Keanu Reeves once said, “Yah, I’m thinking I’m back”.
I’d like to share a few thoughts about a critical new role for video laryngoscopy. With the rapid growth of supraglottic airways as a primary means of securing an airway on cardiac arrests, paramedics are getting fewer opportunities to intubate. This was already a bad situation.
Many parts of the country already have a difficult time maintaining airway skills. In some regions paramedics only get three or four intubations a year. They often have difficulty getting OR training time. These challenges can play in factor in skill deterioration.
Now think about what the impact might be when we move to rescue airways and intubations drop from 3 or 4 to .03 or .04 per year. That does not at all mean the skill is not required anymore. Far from it.
Some specific indications for an advanced airway often occur with breathing patients. One example is airway burns. I want the largest tube I can get in, instantly. Another is frank pulmonary edema with high inspiratory pressures being required to ventilate. A third might be a witnessed asthma arrest. These are all potential walking home saves.
That’s why I think it has become high time everyone had a video laryngoscope. It’s a responsible and cost effective way to prevent DL skill erosion from costing lives that might otherwise be saved.