ArticleInternational journal of emergency medicine2026
Structured correction after difficult direct laryngoscopy during prehospital rapid sequence intubation: an eleven-year physician-staffed helicopter emergency medical service registry study.
Article in International journal of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDifficult laryngoscopy during prehospital rapid sequence intubation may lead to procedural failure and serious adverse outcomes. Evidence is limited regarding whether a structured correction bundle can convert an initial poor view into successful intubation before declaring failure. We evaluated the outcomes of a structured correction protocol used after a poor initial laryngoscopy view during physician-staffed helicopter emergency medical service rapid sequence intubation.
methodsWe conducted a retrospective observational study using prospectively collected data from the Hungarian Air Ambulance airway registry. Patients older than 14 years with maintained circulation who underwent a tracheal intubation attempt between 2012 and 2022 were included. The primary endpoint was the proportion of successful tracheal intubations after at least one corrective maneuver among cases requiring corrective maneuvers. Secondary endpoints included the success rates of individual maneuvers and associations between corrective maneuvers and prespecified covariates.
resultsAmong 2,431 included patients, 1,827 (75.2%) intubations were successfully performed without the need for any corrective maneuvers. The primary endpoint, frequency of successful intubations after at least one corrective maneuver, was achieved in 578 out of 604 cases (95.7%; 95% CI 98.4-99.3). First-pass success in the full cohort was 92.8% (2,255/2,431; 95% CI 91.7-93.8), and overall intubation success was 98.9% (2,405/2,431; 95% CI 98.4-99.3). In 63.7% (385 of 604) of the correction cases, only one maneuver was required. The most common single maneuvers were suction and backward-upward-rightward pressure, each associated with 100% success. The combination of multiple correction elements was also associated with a high success rate. Male sex, cricoid pressure, head-elevated laryngoscopy position, and non-anesthesiology operator specialty were all associated with a higher risk of requiring corrective maneuvers.
conclusionIn this standardized prehospital rapid sequence intubation system, a structured correction protocol after an initially poor direct laryngoscopy view was associated with high rates of subsequent intubation success.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.