Video Laryngoscopy in the Field? Absolutely

Close your eyes... actually open them up, you won't be able to read the description if you close your eyes... Imagine you are on flying on the helicopter for a scene flight.  You land and are brought to the patient, a victim of a motorcycle accident who is clearly in need of an airway.  He is obtunded with sonorous respirations, a GCS of 6, O2 sats in the low 90's.  You start to look and assess the patient's airway and you are decidedly less than pleased.   He is in a cervical collar (not a deal breaker, but complicates things).  He has a decidedly short thyromental distance and the distance between the larynx and the hyoid is also decidedly short, leading you to suspect the patient may have an anterior airway and that on direct laryngoscopy, you likely won't be able to displace the tongue out of your line of sight (1).  He is also not a diminutive man and as you size him up for dosing your induction and paralytic agents you put him roughly at 110 kilos.

You think to yourself... "$#^%.  If I was in the SRU, I'd be pulling out the C-Mac with the D Blade in a heart beat."

But you aren't in the SRU and you definitely don't have a C-Mac with a D Blade in the middle of the cornfield in which you just landed.  You suddenly remember however that you aren't totally out in the cold on this one.  You rifle through the airway bag and pull out your intubating weapon of choice for this very situation - the King Vision LT.   A beautiful bright glowing screen greets you as you turn it on.  You properly prepare, position, and pre oxygenate the patient.  Apenic oxygenation is in place. You defer the pretreatment with fetanyl because of the patients BP of 105/65.  You induce and paralyze the patient after preloading the channel on the King Vision LT with an ET tube.  You advance the King Vision through the oropharynx, seat it and obtain a "cheap seats" Grade I view, centering the glottic opening in the screen.  You advance the ET tube through the glottic opening and into the trachea on your first attempt without even the threat of the patient desat-ing - DASH-1A success.