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Former paramedic here, been out of the field for about 5 years. Leaving a position in academic CCU with anesthesia managing all airways and going to private land MICU/SICU solo coverage of four hospitals (tele-ICU model).

Anesthesia/ED backup is available but our group owns our patients as much as possible. The culture is very much VL (Glidescope) which is of course a big change for me coming from a DL background.

Anyone taken any of the airway courses, Levitan's or The Difficult Airway? Or any other courses? While there is a strong onboarding process in place I'd like to be able to jump back in the game strong.

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I've taken the difficult airway course.  I took the EMS version since it was much cheaper.  The key focus was on how to optimize (ie prepare) the patient for intubation: pre-oxygenation, positioning, etc.  There were a wide variety VL devices, many much better than the Glidescope available for us to try.  However, it was the same intubation mannikins that we used years ago in medic school.  The real challenge in intubation is dealing with all of the anatomical variations and secretions/vomitus in the airway.  In a messy gunk filled airway, VL is actually harder because the fiber optic tip gets covered and provides neither a view or light.  I've heard the Levitan course uses cadavers, so while it's very expensive, it teaches more.

While I have done some VL intubations, using the King Vision and the McGrath Mac, I still most of my intubations via DL with a Mac 4 blade.

Could you spend some time with anesthesia in your current job, or better yet in the ED, to get some hands on before you switch jobs?  That would be your best prep.

 

 

 

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