EASY DOES IT Video laryngoscopes offer an efficient, economical improvement over direct laryngoscopy.

Video-assisted airway management is among the most significant developments that anesthesia providers have seen in the past 2 decades. It's changed the way we take care of our patients. How many times have struggles with difficult airways forced us to change course in mid-procedure? Thanks to video laryngoscopes and stylets, 9 of which we profile on the following pages, many of those challenges are no longer an issue.

Once considered a backup option if you ran into trouble intubating with direct laryngoscopy, video-equipped alternatives can be considered a first choice for routine as well as challenging cases. We can attribute this widespread use to 2 factors.

• Advancing technology. The amazing anatomical view they provide eases providers' placement of endotracheal tubes while reducing the risk of dental damage and post-op sore throats — a definite patient satisfier.

• What's the price to prevent a catastrophe? When one lost airway can easily become a multimillion-dollar lawsuit, a $5,000 to $10,000 tool is a comparatively inexpensive way to minimize a potentially catastrophic risk. From an administrative standpoint, this is a no-brainer.

What to look for in a trial
If you're in the market for an airway visualization device, trialing is relatively easy, especially if you're not test-driving the devices on difficult airways. Some of them fit more comfortably in your hand than others. Low-profile designs can make for easier insertions. A higher-resolution image will be more impressive every time.

The size of the screen actually makes a big difference, and can be a trade-off. A 2-inch display mounted on a laryngoscope handle is a neat innovation, but portability can be a liability when the device has walked away and you suddenly need it. A larger, separate screen connected to the scope by a cable tends to stay where it's needed. It's also easily visible to more than just the anesthesia provider (and a great help to providers with aging eyes), though it can prove bulkier in emergency, on-the-move situations.

Sterility issues are also an important concern. Devices made up of several detachable parts, particularly those combining single-use and reusable components, may speed cleaning and reprocessing as compared to one-piece, permanently mounted scopes. Once your crew starts using video laryngoscopes, it's likely they'll want to use them more and more, so be sure to keep turnaround time in mind.

Airtraq
Airtraq Avant
airtraq.com
(866) 246-6990
Pricing: not disclosed
FYI: Reusable optics enclosed in a disposable blade eliminate the risk of cross-contamination. A docking station recharges the optic components battery and shows its remaining service life (out of 50 uses). The single-use blades are available in regular and small sizes. Offers multiple viewing alternatives, including direct connection to an endoscopic video tower, Airtraq's smartphone app or the company's wif-fi camera. Distributed in the United States by Teleflex Medical (teleflex.com).

Ambu
King Vision Video Laryngoscope
ambuusa.com
(800) 262-8462
Pricing: not disclosed
FYI: Lightweight, self-contained and battery-operated, this laryngoscope combines the convenience of a durable, reusable video display with the safety of a disposable blade. The smudge-proof, non-glare display incorporates LCD technology for crisp images and high-quality color reproduction while also standing up to the wear and tear of normal use and repeated cleaning. The single-use blades, available standard or channeled, prevent cross-contamination between uses.

Clarus Medical
Clarus Video Stylet
clarus-medical.com
(800) 359-2372
Pricing: not disclosed
FYI: This versatile, malleable stylet scope lets you see around tight corners in nearly every patient. The camera positioned at the end of the endotracheal tube provides vision and steering for conclusive intubation through the vocal cords. The LCD display screen can be tethered to a larger monitor or recording device. Quick to set up, simple to operate and easy to clean, the portable device is always prepared for airway management.

Karl Storz Endoscopy
C-MAC Video Laryngoscopy System
karlstorz.com
(424) 218-8100
Pricing: not disclosed
FYI: Karl Storz Endoscopy's multimodal C-MAC Video Laryngoscopy platform offers video laryngoscope, flexible intubation scope and optical stylet options for airway management versatility. The C-MAC Pocket Monitor, for example, is a compact video-equipped unit for portable, flexible use, while the C-MAC S features single-use blades to reduce reprocessing requirements. Each device is available in neonatal, pediatric and adult sizes.

Magaw Medical
CoPilot VL
magawmedical.com
(855) 267-4568
Pricing: $2,999
FYI: Durable and portable, the CoPilot VL includes an external display that is easily mounted to an IV pole or propped up with its kickstand on a flat surface. Its acutely angled blade and patented "bougie port" channel for optional use with a bougie help to manage difficult airways. It can also be used with the included rigid stylet. A rechargeable lithium-polymer battery provides over 2 hours of continuous use, and an anti-fog mechanism keeps visualization clear. Disposable sheaths allow for quick turnover and reduced risk of cross-contamination.

Medtronic
McGrath MAC Enhanced Direct Laryngoscope
medtronic.com
(800) 633-8766
Pricing: not disclosed
FYI: Medtronic's McGrath laryngoscope, which the company acquired in its merger with Covidien earlier this year, is a single-hand-held device that combines the familiar standard technique of a Macintosh direct laryngoscope with the advanced imaging benefits of video laryngoscope technology. Its intuitive operation and slim blade profile offer confident, patient-friendly access to the airway. Its disposable blades and fully immersible body ensure sterile integrity. Both the screen and handle can be treated with high-level disinfection. Drop-tested to 2 meters, the McGrath can endure rough handling in a busy environment.

Olympus America
Olympus Airway Mobilescope
medical.olympusamerica.com
(800) 401-1086
Pricing: not disclosed
FYI: Olympus's line of Airway Mobilescopes combines a monitor, a white LED light source, a battery and a recording device into a convenient, standalone unit, enabling airway access and observations without the need for peripheral equipment or the clutter of cables. A thin insertion tube provides the path for endotracheal tube placement. The 2.5-inch monitor controls operations in a single view. An xD-Picture card lets you capture both still images and video.

UE Medical
VL400 Video Laryngoscope System
uescope.com
(617) 610-2718
Pricing: from $2,850, depending on configuration and options
FYI:: The compact, lightweight VL400 system has been designed with interchangeable components that enable its monitor to play 3 roles: a disposable video laryngoscope, a reusable scope or a video stylet. The monitor can be tilted and rotated to allow intubation and viewing from various positions. A low-profile Mac blade and slightly angled camera allows increased anterior views. The scope, powered by rechargeable lithium batteries, has an optional on-board still image and video recording function.

Verathon
GlideScope Titanium Video Laryngoscopes
verathon.com
(800) 331-2313
Pricing: not disclosed
FYI: Available in reusable and single-use designs, Verathon's new laryngoscopes use thin, low-profile blades for more maneuverability and working space during routine or difficult intubations. The reusable blades feature titanium construction for streamlined durability, while the single-use (modeled on the form and function of the reusable) reduce infection risks. The large video monitor delivers crisp airway views, and snapshot- and video-recording options.