More and more anesthesia providers are reaching for their video laryngoscopes not just for the difficult intubations, but for general intubations as well. Here is what to look for when choosing the best airway visualization device for your facility, as well as a brief overview of 9 of the leading products on the market.

· Display size. Video laryngoscopes come in 2 flavors: those where the camera routes to a monitor directly on the handle and those where the camera is wired to a separate monitor on a cart. Who needs to see the screen and how the picture is displayed are the first 2 things you should consider.

Handheld versions have the camera, blade and monitor all in one device. “Not only is it compact, but it gives the user a clear image and is extremely useful for those difficult intubations,” says Suzanne Christian, an anesthesia tech in the department of anesthesiology at Vanderbilt University Medical Center in Nashville, Tenn.

But the video monitors on the handheld devices are pretty small. “The wide screen is sometimes better, especially at teaching institutions, because everyone can see,” says Julie Kapelan, an anesthesia tech in the department of anesthesiology at Vanderbilt. An advantage to bigger monitors: They're easy to see from the head of the bed, says Ms. Kapelan.

· Camera optics. If you want to capture images and video from the device, then you're in luck. Newer handheld models have the ability to capture images and videos, which used to be a feature only on wired systems. But how the camera takes the image is something to which you should probably pay attention. Some models use a fiber-optic bundle that transmits the image to a camera in the handle, while others have the camera at the end of the blade, says Robert Loeb, MD, professor of anesthesiology at the University of Florida College of Medicine in Gainesville.

He also suggests looking for systems that have the option for rigid and flexible fiber optics. Rigid fiber optics are great for most oral intubations, but if your patient has a profoundly flexed neck or cannot open his mouth more than 2 cm, then having the option for flexible fiber optics will make sure you can intubate in any scenario.

· Blades. Handheld devices generally have a pre-shaped rigid form that you slide a disposable plastic sheath over. You'll have to sterilize reusable blades if you go the non-portable route, but those systems also come with more sizes and styles of blades, which are easy to disassemble from the video and light sources, notes Ms. Kapelan. Some blades have a pronounced curvature that lets you visualize an anterior larynx while others are only slightly better than standard laryngoscopy for visualizing an anterior larynx, says Dr. Loeb.

· Portability. Because everything is included in the palm of your hand, you don't have to worry about cables or carts getting in the way if you go the handheld route. They're great if you're worried about space or need to intubate on the go. And even though the blades are disposable, they're also compact, so a small container is all you'll need to keep them in close range, says Ms. Christian. But the video carts are not as cumbersome as they sound. Yes, the video screen is mounted to a rolling supply cart, but it is compact in size and easy to maneuver, says Ms. Kapelan. You can also store cables, extra blades and difficult airway accessories on the cart.

· Price. The cost between systems can vary pretty widely, according to our experts. Reusable systems tend to be more expensive upfront and “the cost of cleaning, including personnel, should be considered in the price of use,” says Dr. Loeb. “The handheld device is cheaper upfront, but costlier in the long run,” says Ms. Christian. Even though the disposable sheaths are cheaper per item, the cost can add up quickly, says Dr. Loeb. So you'll want to take into account how often you anticipate using these devices to figure out which system suits your facility. OSM