Should Video Laryngoscopy Replace Direct Laryngoscopy as a Primary Intubation Technique?

Purpose of Review While direct laryngoscopy has been the standard technique for tracheal intubation, the application of video laryngoscopy has grown over the past two decades. Early evidence established its beneficial role over direct laryngoscopy for difficult intubations. Recent Findings Summative evidence indicates that video laryngoscopy is superior to direct laryngoscopy for more generalized populations in the operating room. Prior research has questioned the role of video laryngoscopy for tracheal intubation outside of the operating room in emergent situations. More recent evidence has now established video laryngoscopy to be superior for emergent tracheal intubation. Summary Video laryngoscopy is superior to direct laryngoscopy across many clinical environments. However, video laryngoscopy has its limitations and should not be the only tool for airway management. As a result, concerns have been raised that widespread use of video laryngoscopy as a first-line technique may limit needed exposure and practice with direct laryngoscopy and awake tracheal intubation with a flexible scope.