Spoon Feed
In this systematic review and meta-analysis to evaluate the use of a bougie versus non-bougie approach (ie. stylet) in intubations of adult patients, a bougie-first approach significantly increased the rate of first-attempt success compared to controls. But what does this say about your intubation strategy?

Source
Effect of Bougie Use on First-Attempt Success in Tracheal Intubations: A Systematic Review and Meta-Analysis. Ann Emerg Med. 2024 Feb;83(2):132-144. doi: 10.1016/j.annemergmed.2023.08.484. Epub 2023 Sep 19.

Spoon Feed
Underweight (less than 5^th percentile) and obese (over 95^th percentile) children are more likely to suffer hypoxemia and adverse events during tracheal intubation.

Source
Adverse Tracheal Intubation Events in Critically Ill Underweight and Obese Children: Retrospective Study of the National Emergency Airway for Children Registry (2013-2020). Pediatr Crit Care Med. 2024 Feb 1;25(2):147-158. Doi: 10.1097/PCC.0000000000003387.

Dr. Amal Mattu and friends have a new video course you don't want to miss. Take a look!

Spoon Feed
A Bayesian meta-analysis found an 83.2% probability that ketamine lowers mortality compared to etomidate in critically ill patients undergoing intubation.

Source
Ketamine versus etomidate as an induction agent for tracheal intubation in critically ill adults: a Bayesian meta-analysis. Crit Care. 2024 Feb 17.

Dr. Amal Mattu and friends have a new video course you don't want to miss. Take a look!

Spoon Feed
Review of tracheal intubations (TIs) performed in pediatric ICUs found advanced practice registered nurses (APRNs) had a lower first attempt success compared to doctors and respiratory therapists.

Spoon Feed
In adults presenting to EMS after OHCA, those receiving epinephrine prior to advanced airway management (AAM = supraglottic airway, SGA, or endotracheal tube) experienced better outcomes and prehospital ROSC than those receiving AAM before epinephrine. This was true for both shockable and non-shockable initial rhythms.

Source
Sequence of Epinephrine and Advanced Airway Placement After Out-of-Hospital Cardiac Arrest. JAMA Netw Open. 2024 Feb 5;7(2):e2356863. doi: 10.1001/jamanetworkopen.2023.56863.

Spoon Feed
A panel of experts appraising a systematic review on prehospital airway management created 22 recommendations relating to ventilation (BVM vs SGA vs ETI), video laryngoscopy (VL), and drug-assisted airway management.

Source
Evidence-Based Guideline for Prehospital Airway Management. Prehosp Emerg Care. 2023. Dec 22. Doi: 10.1080/10903127.2023.2281363. Online ahead of print.

Spoon Feed
When providing respiratory support to preterm infants with a facemask, avoid excessive force on the face that is associated with apnea and bradycardia.

Source
Exerted force on the face mask in preterm infants at birth is associated with apnoea and bradycardia. Resuscitation. 2024;194:110086.

Spoon Feed
In patients with suspected acute poisoning who are comatose, a more restrictive intubation approach where intubation is withheld unless an accompanying emergent indication is present, may lead to fewer ICU admissions, decreased ICU length of stay, and decreased requirement for mechanical ventilation, with fewer adverse events.

Source
Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning: A Randomized Clinical Trial. JAMA. 2023 Dec 19;330(23):2267-2274. doi: 10.1001/jama.2023.24391.

Spoon Feed
For the majority of out-of-hospital cardiac arrest (OHCA) patients undergoing standard (30:2 compressions:breaths) cardiopulmonary resuscitation (CPR) prior to definitive airway placement, bag-valve mask (BVM) ventilations did not achieve adequate lung volumes most of the time. Receiving adequate BVM ventilations >50% of the time was associated with significantly higher rates of return of spontaneous circulation (ROSC) and survival.

Source
Bag-Valve-Mask Ventilation and Survival from Out-of-Hospital Cardiac Arrest: A Multicenter Study. Circulation. 2023 Nov 12. doi: 10.1161/CIRCULATIONAHA.123.065561. Epub ahead of print.

Spoon Feed
This single center RCT found no difference in maximum Sequential Organ Failure Assessment (SOFA) score between critically ill adult ED patients receiving ketamine vs etomidate for rapid sequence intubation (RSI). 

Source
The Effect of Ketamine Versus Etomidate for Rapid Sequence Intubation on Maximum Sequential Organ Failure Assessment Score: A Randomized Clinical Trial. The Journal of Emergency Medicine, Volume 65, Issue 5, 2023, Pages e371-e382, ISSN 0736-4679, https://doi.org/10.1016/j.jemermed.2023.06.009.