Advantages Of Video Laryngoscope

1. Advantages of video laryngoscope
There is no doubt that videolaryngoscopy has been one of the major advances in anesthesia practice in recent years. The main challenge is to determine to what extent videolaryngoscopy should be used in routine clinical practice and which videolaryngoscope will perform best. Going from a standard Macintosh laryngoscope to a video laryngoscope is like going from a standard mobile phone to a smartphone. There have been calls for videolaryngoscopy as a first-line tool for airway management. Most importantly, in the 2015 guidelines of the British Difficult Airway Association, the role of videolaryngoscopy in the management of difficult tracheal intubation has been recognized. The guideline recommends that all anesthesiologists should be trained in the use of videolaryngoscopes and have immediate access to videolaryngoscopes at any time. Furthermore, videolaryngoscopy has been recommended for endotracheal intubation in obese patients, who are known to be at higher risk of airway management-related complications. Beyond the field of anesthesia, it has been predicted that videolaryngoscopy will dominate the field of emergency airway management in the future. Price appears to be the main factor holding back the tide for now. The main reasons that make people enthusiastic about video laryngoscopy are as follows:

(1) Technical advantages
Video laryngoscopes have many technical advantages. Compared with the standard Macintosh laryngoscope (direct laryngoscope), the video laryngoscope can provide users with a better view of the larynx. The improved view of the laryngoscope is due to two factors: video laryngoscopes with Macintosh lenses have a camera at the distal end of the lens that provides a larger field of view than direct laryngoscopes; , this expanded field of view can be enhanced by its ability to “see around the corner” and view airway structures that lie outside the field of view of the Macintosh lens. This improved laryngeal view can be obtained with videolaryngoscopy even with minimal head and neck manipulation. Therefore, appropriate selection of video laryngoscope is beneficial to predictable or unforeseen difficulties in direct laryngoscopy.

The force required for endotracheal intubation by videolaryngoscope is significantly smaller than that by direct laryngoscope, which can reduce the risk of soft tissue and tooth damage, and reduce the incidence of sore throat. When used as a rescue tool for failure of direct laryngoscopy, videolaryngoscope has a higher success rate of tracheal intubation. Since most difficult intubations are unanticipated, using videolaryngoscopy as a first-line tool not only reduces the risk of difficult intubation, but also avoids intubation when timing and oxygenation are critical. Tube tool conversion needs. If videolaryngoscopy is used as a first-line tool, the number of laryngoscopy exposure attempts will be kept to a minimum and unforeseen difficult intubation is likely to occur rarely.

(2) Training advantages
Video laryngoscopy has clear training advantages. When the trainee performs laryngoscope exposure operation, the trainer can see the airway structure on the monitor, so as to help the trainee place the lens in the ideal position, and guide the trainee by pointing out the necessary anatomical landmarks on the monitor Where is the endotracheal tube inserted. Because images of the larynx are visible to both the trainer and the trainee, and the technique can be optimized in real time, the trainee is more likely to intubate independently without the trainer taking over. This is especially useful for rapid sequential induction of anesthesia and patients at risk of hypoxia. Whether the trainee is allowed to look at the monitor during the procedure or simply use the videolaryngoscope as a direct laryngoscope (seeing the monitor only when the larynx is difficult to expose) depends on the purpose of the training. Many studies have shown that the use of video laryngoscope is more effective than standard Macintosh laryngoscope in training novices for direct laryngoscopy and endotracheal intubation.

(3) Non-technical or human-related advantages
Videolaryngoscopy has distinct advantages that are not technical or human factors related. During endotracheal intubation, the entire team can see the image of the larynx, improving teamwork and communication. The anesthesia assistant can easily see the intubator’s ongoing efforts and can predict the “next step” to ensure that the necessary equipment is immediately available. When cricoid compression is performed, the anesthesia assistant can assess whether the maneuver improves laryngeal exposure, or conversely displaces the larynx or wrongly compresses the larynx making the view of the larynx worse, so that the anesthesia assistant can make immediate adjustments as needed Direction and degree of cricoid compression. Furthermore, videolaryngoscopy can also help trainee anesthesia assistants learn how to perform cricoid compression, while supervisors can directly supervise them and help them adjust the operation when needed.