Ramped Position Not Superior to Sniffing Position for Intubating Critical Care Patients

In this study of intensive care unit patients, the ramped position did not reduce rates of desaturation, and it increased the difficulty of intubation.

These authors performed a multicenter randomized trial to compare the ramped versus the sniffing position for intubating intensive care unit (ICU) patients. A total of 260 adult patients at four U.S. tertiary care center ICUs were assigned to either have the head of the bed elevated to 25 degrees (ramped position) or folded blankets or towels placed under the patient's head and neck to elevate and extend only the head (sniffing position; the most commonly used position).

Sepsis, altered mental status, and pneumonia were the most common indications for intubation. The median lowest pulse oxygen saturation was similar in the sniffing position and ramped position groups (92% and 93%). However, the ramped position group had significantly worse o…

Reviewing Author

Richard L. Byyny, MD, MSc, FACEP

Disclosures

EquityZimmer; Aetna

Editorial BoardsAmerican College of Emergency Physicians Clinical Policies Committee

Richard L. Byyny, MD, MSc, FACEP

Disclosures

EquityZimmer; Aetna

Editorial BoardsAmerican College of Emergency Physicians Clinical Policies Committee

Ramped Position Not Superior to Sniffing Position for Intubating Critical Care Patients

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Reviewing Author