I made the same conclusion as your line. And we’re gonna go full vl in our hospital, even if it’s not optimal for MD. We’re gonna do it for the young medical student and mostly for our patients. Thanks for the video :)
Appreciate you watching and taking time to leave a comment. Congrats on the hospital going to VL...that is not a simple thing to get done at most places. :)
Excellent video, very informative! One minor point: the DEVICE trial didn’t prescribe VL blade type. Standard geometry blades predominated, but some patients were intubated with a hyperangulated blade. I don’t recall them parsing outcomes between VL blade types, but that would’ve been interesting.
Don't disagree with your point ;) ...Of the 705 patients intubated with VL 607 were with standard geometry (86%) and 98 (14%) with hyperangulated blades. Since nearly 90% of the VL group was standard geometry it is essentially a standard geometry group.
@@SalimRezaie thanks for the reply. Although I wasn’t thinking this way with the initial comment, and I have limited insight when it comes to the stats of these sorts of things, I’m genuinely wondering now: Is there a way of deciding if that 7% being hyperangulated is significant to the outcome, by considering it relative to the difference in primary outcome (of about 15%)? My phrasing is weird but I’m unsure how better to phrase it.
There really isn't a way to tell...but if 90% of a population uses standard geometry then the population is essentially standard geometry...sure there is some potential dilutional component when it's not a 100% of the population...but hey...that's medicine isn't it? Take the best info/data (which is never perfect) and apply it to the patient in front of you. Hope that helps.
I think the argument for hyperangulated vs standard geometry is going to be up to provider and characteristics of patient needing intubation...but I do believe we have ample evidence that VL is much better than DL (especially in trainees).
