Dr. Sharma makes some very valid observations about the efficacy of the GlideScope® (Verathon Medical, Bothell, WA) and how, with this device, visualization of glottic structures can sometimes be accompanied by a frustrating inability to actually pass an endotracheal tube. Nevertheless, the GlideScope® is just one of a wide variety of video-assisted intubation devices that are now being used with increasing frequency, often as a first-line instrument. My principal concern, which prompted the correspondence,1
is that neither is there currently a standard for documenting the use of these devices nor is there a consistent means of informing the patient that such a device was used. This could have significant implications for a future anesthetic, particularly if the anesthesia provider does not have access to a video-assisted device.
In the time since my initial correspondence, I have devised a difficult-intubation letter, which takes the form of an Excel spreadsheet template (Microsoft Corporation, Redmond, WA); it has drop-down menu choices for all of the key elements of a patient's airway evaluation and instrumentation. It takes less than a minute to complete, has been adopted by our large group practice, and is currently being translated into a variety of languages. I am happy to share this with anyone who is interested.
Glynne D. Stanley, M.B., Ch.B., F.R.C.A.
North Shore Medical Center, Salem, Massachusetts, and Anesthesia Associates of Massachusetts, Westwood, Massachusetts. firstname.lastname@example.org
1.Stanley GD: Is it time for a GlideScope letter? Anesthesiology 2009; 111:1391
© 2010 American Society of Anesthesiologists, Inc.