Methodology: 2/5
Usefulness: 4/5

Brown CA 3rd, et al. Acad Emerg Med. 2020 Feb;27(2):100-108.

Question and Methods: This was one the largest prospective, observational, ED-only airway studies to date comparing first-pass success (FPS) rates in “augmented” DL (A-DL) intubations with unaided VL intubations.

Findings: FPS for unaided VL: 90.9% (95%CI 88.7-93.1%) vs. A-DL: 81.1%(78.7-83.5%). Multivariable AOR was 2.8 (2.4-3.3) in favour of VL. No difference in recorded adverse events.

Limitations: This was a self-reported, observational study subjected to confounding, recall, and selection bias. In addition, many patients were missing recorded predictors of airway difficulty.

Interpretation: This secondary analysis provides good observational evidence that for an all-comer ED cohort, including difficult airways, unaided VL likely outperforms augmented DL for FPS.

By: Dr. Adam Parks

Hans Rosenberg
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.