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

Author

  • 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.