A laryngoscope which offers both Video & Direct laryngoscopy will often be superior to either alone.
The only real factor limiting general access to VL&DL laryngoscopes is cost.
Unfortunately, in healthcare our ability to quantify the financial loss of working without the best equipment is poor. As a result it’s difficult to assess the cost of failure to intubate well (with minimal sequelae) at the first attempt.
Sadly the mark up on many VL&DLs is astronomical, to the detriment of patients and front line staff (see here).
Consider that those who may be faced with the most difficult intubations – paramedics – are least able to access the best tools – this needs to change.
The challenge is to obtain the best VL&DL laryngoscope at the best price so it’s available (if wanted) for all intubations.
See below for what might be considered the best features of a laryngoscope. Please provide comment, feedback and any suggested revisions to this list
– most likely to be successful for most intubation scenarios
– light weight
– low cost (laryngoscope handle, blades, batteries)
– decreased blade thickness for small mouth opening
– NO blade channel
– blade angles: view using DL is as good as a Macintosh
– blade angles: ease of hyperacute (?attachment and access)
– still functions well in sun glare
– battery performance
– familiarity of use (use of laryngoscope replicates that of direct laryngoscopy – negates need to learn a different technique)
The challenge is to:
1. get your hands on these reasonably priced good VL&DL to assess (for free)
2. assess them in simulated environments with staff at all levels & provide feedback
3. barter for the best price
4. obtain TGA (FDA/MHRA/other) approval
5. make suitable devices available at all intubation locations
Below are some examples that may be suitable (click on each image for further info). Some are on sale for $500 US – perhaps you might obtain them for less. There’s many more on this website (see here)
MAYA MA SMT-I-B