PHARM PODCAST 104 : VL vs DL with Levitan and Strayer

 

Image from Twitter. No financial disclosures

Image from Twitter. No financial disclosures

Hi Folks

On today’s show, Dr Richard Levitan and Dr Reuben Strayer debate and discuss the topic of Video Laryngoscopy vs Traditional Direct laryngoscopy.

Prediction is that in 2020, we will all be using BOTH! I still believe VL is a luxury, not a necessity but I do admit it has a definite role and is here to stay.

Listen up folks!

Check out this great educational video from Dr Larry Mellick in regard to pitfalls of VL.

 

 
Now, onto the PODCAST!

[audio

http://media.blubrry.com/prehospitalpodcast/content.blubrry.com/prehospitalpodcast/PHARM-2014-08-26-107.mp3%5D

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7 Comments
  1. Great podcast!

    My concern that VL may promote the breeding of bad habits is that one can relatively easily get a great view using VL without optimizing positioning nor creating space nor having a good angle (more straight/direct and less hyperangulated) for tube delivery.

    DL approaches where you need to make a direct line of sight from your eye to the glottis, forces one to lift to see and align the airway axes to get an adequate view. This is not necessary in VL especially with the hyperangulated blades (original glidescope blade and CMAC D-blade) but also the near 90 degree blades like Airtraq. I do like the approach of using VL with a direct blade in a DL method first always and then switching to the screen if necessary or in order to practice indirect tube delivery.

    Tube delivery struggles with VL are multifactorial however much of the reason may rest on inadequate positioning, space and angle for tube maneuvering and delivery. With VL I think there is the tendency to stop after epiglottoscopy and laryngeal exposure and then forget about optimizing the tube delivery situation with ensuring good positioning, avoiding going too deep and tilted into the airway and ensuring tongue and jaw are lifted, having glottis in the northern half of screen and adequate screen tube delivery space.

    Thanks for all of the medical education and research work that all three of you do! It continues to help my knowledge, skills and opportunity to pass this on to others.

    Yen

  2. Huge thanks to all for getting your heads around that question.
    Having an interesting chat about that topic at ED and was wondering what everyone felt.

    I’m glad my 140 character question made sense.

  3. Hi Minh,

    As you know, I really believe in the power of the DL+VL devices (devices I will now call “video enabled standard geometry blades”) when they are used by providers who understand the mechanics.

    My hat is off to you as well as the good Drs. Levitan and Strayer as these 69 minutes might well be the most eloquent and beautifully intelligible on the subject to date.

    Cheers,

    Mike

    • Thanks Mike
      I can’t believe you measured your own anterior tibial compartment pressure !
      Kick the tyres , light the fires , folks ! We have a riding star of FOAMED here!

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