The ascent of video laryngoscopy over the lifetime of the GlideScope has been particularly gratifying and is leading many to advocate the use of Video Laryngoscopy as a first line management tool. The variety of valid opinion will continue to grow and care givers will continue to "customize their approach " based on the skills and equipment available. There is however, an emerging standard that builds on the wisdom of the ASA Difficult Airway Algorithm and in Canada the CAS Difficult Airway study group Algorithm which requires that skills and equipment be available in the following key areas.

1. The Direct Laryngoscopy approach
2. Video Laryngoscopy
3. Flexible scope technology application
4. Supraglottic airway use and skill
5. Direct surgical airway capability applied in extreme situations
6. Supportive adjuncts such as the Verathon Stylet, the Bougie, the Endotracheal tube exchange catheter,  optical stylets, and oral /  nasal airways.
 
    The use of these pieces of equipment in combined approaches may feature the GlideScope and a Flexible scope  or an Airway exchange catheter together in some circumstances. The power of the new devices can only be fully realized when practitioner skills span the full range of airway offerings. What we are seeing now, is the maturation of  the teaching systems such as -simulation workshops, clinical resource optimization exercises on manikins, airway rotations with deliberate planning to be certain that the output of trainees is standardized at a high level, and team competitions that challenge ones skills in a friendly but serious manner.
 
  Truly an impressive amount of progress !