In my airway education travels, I meet folks who claim no need for endoscopy skills. While it’s true you can be an emergency physician and not know how to do nasoendoscopy or long-scope intubation, the real question is, why would you? You can live without a dog, but why would you? You can be an emergency physician and not know ultrasound (coming up with ways to punt, work around, or make excuses), but let’s face it—the more you put in the “I don’t do that” column, the more uncomfortable you will be with the great challenge of being an emergency physician. Conversely, the less you fear, the easier it is to stand at the front door of your hospital, ready for anything, which is no easy task. It’s about making peace with the challenge you’ve accepted.
Until I felt really confident with an endoscope, I was particularly scared about trach changes, dislodged trachs, angioedema, Ludwig’s angina, and other airway challenges that I felt I needed otolaryngology/anesthesia to address. I still respect all of these things and appreciate the expertise our consultants can provide, if they’re available. Let’s not fool ourselves; patients are ours, and we are responsible for them. In some venues, like where I now work in rural New England, we are all they have.