• Am J Emerg Med · Sep 2024

    Review

    Emergency medicine updates: Endotracheal intubation.

    • Brit Long and Michael Gottlieb.
    • SAUSHEC, Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA. Electronic address: Brit.long@yahoo.com.
    • Am J Emerg Med. 2024 Sep 3; 85: 108116108-116.

    IntroductionAirway management including endotracheal intubation (ETI) is a key skill for emergency clinicians. Therefore, it is important for emergency clinicians to be aware of the current evidence regarding the identification and management of patients requiring ETI.ObjectiveThis paper evaluates key evidence-based updates concerning ETI for the emergency clinician.DiscussionETI is commonly performed in the emergency department (ED) setting but has many nuanced components. There are several tools that have been used to predict a difficult airway which incorporate anatomic and physiologic features. While helpful, these tools should not be used in isolation. Preoxygenation and apneic oxygenation are recommended to reduce the risk of desaturation and patient decompensation, particularly with noninvasive ventilation in critically ill patients. Induction and neuromuscular blocking medications should be tailored to the clinical scenario. Video laryngoscopy is superior to direct laryngoscopy among novice users, while both techniques are reasonable among more experienced clinicians. Recent literature suggests using a bougie during the first attempt. Point-of-care ultrasound is helpful for confirming correct placement and depth of the endotracheal tube.ConclusionsAn understanding of literature updates can improve the ED care of patients requiring emergent intubation.Published by Elsevier Inc.

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