Airway

Ketamine vs Etomidate RCT- Which Causes Higher SOFA Score? 

Airway, Critical Care

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. 

Rethinking Appropriate ETT Insertion Depth in Children

Airway, Pediatrics

First, a quick poll – How do you determine ETT depth in kids?

What’s your method? Take the poll!

Spoon Feed
Formula-based calculations for ETT depth in pediatric patients are based on a linear curve, despite children’s growth not being linear or uniform. Looking at age, height, and weight, these authors provide ETT depth recommendations based on calculated best-fit curves.

Source
Recommendations for endotracheal tube insertion depths in children. Emerg Med J. 2023. Aug;40(8):583-587. Doi: 10.1136/emermed-2022-212494.

How to Get the Best Glottic View in Kids

Airway, Pediatrics

Spoon Feed
Emergency intubation in children has similar procedural success rates when directly or indirectly lifting the epiglottis. When indirectly lifting the epiglottis, engagement of the median glossoepiglottic fold is associated with better visualization and success.

Source
The Importance of Median Glossoepiglottic Fold Engagement on Laryngeal View and Tracheal Intubation Success in Children. Ann Emerg Med. 2023 Jun;81(6):658-666. doi: 10.1016/j.annemergmed.2022.12.027. Epub 2023 Feb 15.

DEVICE RCT – VL vs DL for Critically Ill Adults

Airway, Critical Care

Spoon Feed
Video laryngoscopy (VL) was associated with higher rates of first attempt intubation success compared to direct laryngoscopy (DL) for critically ill patients in the ICU and ED. Furthermore, use of VL was associated with better views of the glottis and was especially helpful for clinicians with less intubation experience.

Source
Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults [published online ahead of print, 2023 Jun 16]. N Engl J Med. 2023;10.1056/NEJMoa2301601. doi:10.1056/NEJMoa2301601

What Is “First Pass Success” Anyway? Defining Outcomes That Matter in Airway Research

Airway

Spoon Feed
These authors propose that the definition of a successful first attempt during intubation should be placement of an endotracheal tube (ETT) in the trachea after a single insertion of a laryngoscope followed by a single ETT insertion.

Source
Defining successful intubation on the first attempt using both laryngoscope and endotracheal tube insertions: a secondary analysis of clinical trial data.  Ann Emerg Med. 2023 Apr 17;S0196-0644(23)00213-5.

Scroll to Top