In obese patients, when should video laryngoscopy be considered?

• A. Early use to facilitate visualization and intubation.
• B. Only after failure of direct laryngoscopy.
• C. Not recommended due to obstruction by adipose tissue.
• D. Only in non-obese patients.

Answer: (A)

In obese patients, airway management is often more challenging due to excess soft tissue and limited neck mobility, which can make direct visualization of the glottis unreliable. Video laryngoscopy provides an indirect, camera-assisted view of the vocal cords on a screen, usually yielding a better glottic view than direct laryngoscopy and reducing the need to perfectly align the airway axes. Because these patients desaturate quickly, securing the airway sooner with a tool that improves visualization and increases the likelihood of first-pass success is advantageous. So, using video laryngoscopy early to facilitate visualization and intubation is the best approach.