First-Pass Intubation of Critically Ill Patients Is More Likely with Video Laryngoscopy

Traditionally, intubation has been done with direct laryngoscopy, where the clinician places the endotracheal tube by visualizing the vocal cords through the mouth. In the last several years, video laryngoscopy has become popular, because the camera on the laryngoscope allows the clinician to see the path to intubation on a screen. Studies comparing these two approaches for intubation in the operating room have yielded mixed results. No large trials have been designed to compare these methods in critically ill patients in the emergency department (ED) or intensive care unit (ICU).

Investigators randomized 1400 patients from 17 U.S. sites (7 EDs and 10 ICUs) to either direct or video laryngoscopy. Most patients were intubated in the ED, most …