I think each provider must decide if she will become the master of the emergent airway or not.
If you so choose, then you must master DL and all adjuncts. VL is a nothing more than an adjunct.
I have found more airways that could not be secured with VL than DL. Of course, more than 95% can be secured with both and there is a very small percent than can be secured with neither DL nor VL.
If I was in training again now -- and not in EM or anesthesiology -- I would focus on VL, good BVM, LMA, and cric.
I can't offer an informed opinion regarding anesthesiology training, but if I was training in EM again, I would learn VL but realize DL is my back up (yes, this is opposite of what is usually taught) and DL is my go to. EM docs must be masters of the emergent airway (which is very distinct from the OR elective airway). I would focus on the bougie, iLMA, and cric as well.
Of course, I think the modern EM doc should also be familiar with awake bronchoscopic intubation as well...but that is for a different thread.
HH
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Mac or miller blade?
