Why First Pass Success?
Best review article – first-shot-is-the-best-shot
Each Attempt Makes Things Worse
Hasegawa et al. showed at 3 attempts, things got bad (Ann Emerg Med 2012;60:749)
Sackles JC et al. showed that >1 attempt radically increased complications (ACADEMIC EMERGENCY MEDICINE 2013; 20:71–78)
Mort demonstrated this in the ICU, after two attempts risk of crit desat (70%) is huge and assoc. with cardiopulm arrest (Anesth Analg 2004;99:607)
Mort has further elaboration re: the dangers of intubation in the critically ill (J Inten Care Med 2007;22(4):208)
Heffner et al. showed a 4% cardiac arrest rate in ED intubations (Incidence and factors associated with cardiac arrest complicating emergency airway management. Resus 2013)
Duggan showed >1 attempt = badness
Learning Curve for Laryngoscopy
- Best review of lit is at Openairway
- How many general ED docs do: Ann Emerg Med. 2019 Jun 24. doi: 10.1016/j.annemergmed.2019.04.025.
- How many they need to do: West J Emerg Med. 2019 Jul;20(4):601-609. doi: 10.5811/westjem.2019.6.42946.
VL Teaches DL
This letter has a discussion and pertinent references (BJA 2017;119(4):842–843)