So, the other day I had a patient who was in my estimation a difficult airway with a small mouth opening, Mallampati class 3 and just almost 2 finger breadths thyro-mental distance exam. His neck ROM was normal and he'd not been intubated in the past. So I had a glidescope in the room but decided to look first with conventional Miller 3 blade. As I expected, grade 4 view even with neck readjustment. So, I glidescoped him and it was as easy as could be. After the case, I asked my MDA to send a letter to the patient and he said we didn't need to, that the patient was easy with a glide. I said but not all hospitals have glidescopes and shouldn't we tell the patient our issues? He said the letter needs to change b/c it didn't address glidescope intubations and that was all. So, after about a couple of hours, I went upstairs and in person explained to the family and the patient my issues with his airway. I wrote it down for them and wrote that it was and easy intubation with a glidescope and he should always tell his health care providers of this issue and perhaps wear a bracelet if he wanted. He and his family were grateful.

So, are you all sending letters these days and just b/c he can be intubated with a glidescope should that stop us from informing the patient of the difficulty of securing his airway with conventional means?