Remember that extubation is just as important as intubation. "In
this age of electronic re-cords, team members can turn their backs
on the patient at the end of the case," says Dr. Hag-berg, "but you
must remain vigilant at the beginning and end of each and every
case."
Another subtle change that's being heralded as a critical compo-
nent of airway management success: oxygenation. "One of the
biggest changes we're seeing today in airway management is the
performance of oxygenation throughout the process of securing
the airway by apneic oxygenation techniques," says Dr. Hagberg.
"A change that's already starting to be incorporated into some of
the difficult airway guidelines is the use of oxygenation through-
out, instead of between, the performance of airway management."
Perhaps the best strategy for difficult airway management lies in treat-
ing every airway as a potentially challenging intubation because, as Dr.
Hagberg points out by paraphrasing renowned airway expert Tim Cook,
MD, "The biggest mistake practitioners make is the failure to plan for
failure."
OSM
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"You want the device to feel like an old friend as opposed to
feeling like, I've got this new tool that feels fancy, but also a little
foreign," says Dr. Charnin.
Other considerations: ease of use, ergonomics, image quality,
portability and screen size. For example, is the viewing screen
integrated into the video laryngoscope's handle or does a
fiberoptic cable tether the handle to a separate monitor?
Smaller screens integrated into the handle let providers use the
device without averting their focus from the patient. "That's a
must-have feature for some anesthesia providers," says Dr.
Charnin. — Jared Bilski