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Related Concept Videos

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Endotracheal Intubation I: Procedure01:15

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Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
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Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
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Endotracheal Tube Extubation01:24

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Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
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Endotracheal Intubation II: Nursing Management01:17

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Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
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Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
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Related Experiment Video

Updated: Apr 12, 2026

Endotracheal Intubation Using a Flexible Intubation Endoscope as a Standardized Model for Safe Airway Management in Swine
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Changes in Cormack-Lehane View Between First and Second Emergency Department Intubation Attempts.

Dhimitri A Nikolla1, Muhammad Rajput2, Baltazar Osorio1

  • 1Department of Emergency Medicine, Allegheny Health Network, Erie, Pennsylvania.

The Journal of Emergency Medicine
|April 10, 2026
PubMed
Summary
This summary is machine-generated.

The glottic view often changes between intubation attempts, even with the same provider. This highlights variability in airway visualization during emergency department intubations.

Keywords:
critical illnessemergency medicinehealth registrieslaryngoscopytracheal intubation

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Area of Science:

  • Emergency Medicine
  • Anesthesiology
  • Airway Management

Background:

  • Effective airway management is crucial in emergency settings.
  • The Cormack-Lehane classification assesses glottic view during intubation.
  • Understanding changes in glottic view between attempts informs clinical practice.

Purpose of the Study:

  • To evaluate the agreement of glottic views (Cormack-Lehane grade) between the first and second intubation attempts.
  • To compare view agreement when different providers perform the attempts versus the same provider.

Main Methods:

  • Retrospective cohort study of 640 emergency department (ED) intubations from the National Emergency Airway Registry (2016-2018).
  • Analysis of adult patients receiving sedative and paralytic agents with multiple intubation attempts.
  • Exclusion of cases with altered equipment, positioning, or manipulation between attempts.
  • Categorization into 'different intubator' and 'same intubator' cohorts.

Main Results:

  • The Cormack-Lehane grade remained the same in 50.0% of cases when different providers attempted intubation (kappa = 0.40).
  • The glottic view was consistent in 72.0% of cases when the same provider performed both attempts (kappa = 0.53).
  • Significant changes in glottic view occurred in half of cases with provider change and over a quarter with the same provider.

Conclusions:

  • Glottic view consistency is moderate between sequential intubation attempts in the ED.
  • Provider changes significantly impact glottic view stability.
  • These findings underscore the dynamic nature of airway visualization during difficult intubations.