Glidescope+aScope = Win for Difficult Airway
In patients with predicted difficult airway, use of a Glidescope plus fiberoptic scope (aScope, Ambu) as a dynamic, controllable stylet vs Glidescope with usual stylet resulted in much higher first-pass success, 91% vs 67%, NNT = 4.
Simple New Test for Difficult Airway
An abnormal upper lip bite test, in which the patient’s lower incisors cannot extend to reach the upper lip, increases the probability of a difficult intubation from 10% to greater than 60%.
PreVent RCT – Bag-Mask Ventilation During RSI?
Providing bag-mask ventilation (BMV) during the apneic phase of RSI improved oxygenation compared to standard RSI and did not increase the rate of complications.
Succinylcholine or Rocuronium – Which Is Better?
A large observational series with over 4,000 intubations compared succinylcholine vs. rocuronium in rapid sequence intubation and found no association between these two paralytics and first-pass intubation success or peri-intubation adverse effects.
PROTRACH – HFNC for Preoxygenation in the ICU
High-flow nasal cannula (HFNC) compared to bag-valve mask (BVM) ventilation for preoxygenation of critically ill patients did not improve lowest SpO2 but significantly reduced severe complications (SpO2 < 80%, severe hypotension, and cardiac arrest); 6% HFNC vs. 16% BVM, NNT = 10.
Apneic Oxygenation In the PED
Apneic oxygenation works in children, with half as many becoming hypoxemic during endotracheal intubation.
ETT vs. SGA for OHCA – Metaanalysis Includes AIRWAYS-2 and PART
There was no difference in an endotracheal tube vs supraglottic airway for patients with out-of-hospital cardiac arrest in the outcomes of return of spontaneous circulation, survival to admission, survival to discharge, or survival with good neurological outcome in studies with low risk of bias in this large metaanalysis.
An Easy Way To Simplify Intubation During Arrest
Video laryngoscopy improved first-pass success over direct laryngoscopy when intubating during cardiac arrest, 78% vs 70%, respectively.
A Great Way to Do Apneic Oxygenation – Buccal O2
Delivery of buccal oxygen as a form of apneic oxygenation was highly effective and safe.
Which Is Better – VL or DL?
Video laryngoscopy gets the green light from Academic Emergency Medicine over direct laryngoscopy - clear benefit, no harm. For every 17 intubations using VL, one less patient will have a failed intubation.