Standard video laryngoscopes (VL), such as the Storz C-MACTM system, are increasingly commonly used. All personnel should become familiar with their use and limitations. A recent systematic review concluded that VL of all designs likely reduce rates of failed intubations and improve first pass success, and their use is suggested by the BJA 2018 Guidelines for the management of tracheal intubation in critically ill adults [6,7].

Potential limitations include difficulty to pass the tube despite greater glottic view, fogging and secretions obscuring the video, equipment failure, and lack of familiarity with standardised grading of airway (i.e. Percentage of glottic opening – POGO) [8].

The types and modifications of VL equipment continues to expand and therefore airway providers need to consider multiple factors, including the shape of the blade, portability, and whether they are channelled. Blade choice is divided into Macintosh or hyperangulated blades, which can be further subdivided into channelled or non-channelled blades. [9].
 

The hyperangulated VL blades (C-MACTM Dorges “D” blade, or GlideScope® LoPro) offer a distinct advantage in that they conform to the primary oropharyngeal curve, providing enhanced visualisation of the glottis with reduced head and neck manipulation. However, it requires a significant learning curve to master its use and frequently requires the use of an intubating aid (preformed stylet, an equipment specific stylet, or bougie). Instead of entering the corner of the mouth and sweeping the tongue to the left, they use a midline “point and shoot” technique with a channelled device or a midline, guided technique with a styletted angulated endotracheal tube or bougie in an un-channelled device. They are the device of choice as a secondary blade after failed intubation with a video laryngoscope and Macintosh blade and bougie.