Over the past several, I have seen an escalating usage of the Glidescope at my hospital. When it was first brought in, I saw it used occasionally for suspected difficult airways, but now it is hard to get a hold of (almost have to get a tech to reserve it for your case). I think the reliance on newer technology and imaging is overall a good thing. We don't have nearly as many awake FOI, and we almost never get called to the ER for intubations. However, I wonder if all of this will become the new standard of care (as many believe that ultrasound is the standard of care for line placement). In the above retrospective review of 2000 patients, the Glidescope was effective in 94% of the cases when DL failed. Pretty good numbers. Should all MAC/Miller blades be replaced by videoscopes? I think not, and still believe that such technology is best used in patient specific situations. Still, I wonder if this is where we are heading. Glidescopes for all intubations, ultrasound for all lines (a-lines too), blocks, epidurals and spinals. I hope not, as I think there is still some value in "hand" skills. Just my opinion as an older person. Lastly, and most importantly, as good as the Glide is, it was not successful in all cases. Specifically, pts with altered airway anatomy: tumors, radiation, congenital malformation. So the Glidescope is good most of the time (but not all the time).