You are on page 1of 1

Name

Designation: resident/fellow/consultant/chairman/others pls specify:

Contact Number

Hospital

Primary/Secondary/Tertiary

Private/Govt

Luz/Vis/Min

Current brand of videolaryngoscope in your hospital:

karl storz/glidescope/intubrite/hugemed/others pls specify:

Number of intubations in 1 week

0-5, 6-10, others pls specify:

Preferred expert intubation options:

Flexible Intubation, Rigid Intubation, Both

Number of anesthesia machines in your institution:

Current brand of anesthesia machine:

Drager, Mindray, GE, Others pls specify:

Number of vaporizer in your current anesthesia machine:

Most useful feature in your current anesthesia machine

Do you have a current need for anesthesia machines?

You might also like