Podcast 1010: First Pass Intubation Success

Podcast 1010: First Pass Intubation Success

From Emergency Medical Minute by Emergency Medical Minute

June 29, 2026 · 4 min

About this episode

This episode discusses the importance of first-pass intubation success and strategies to improve it.

Contributor: Travis Barlock, MD Educational Pearls: First-pass success is critical to limit complications from apnea, hypoxia, and airway trauma. Complication rate for patients intubated on the first pass is 14% Complication rates increase to 47% after two attempts, 64% after three, and 71% after the fourth attempt How to improve likelihood of first-pass success: Use Video laryngoscopy (VL). VL increases chance of first-pass success to 85% from 71% Use a bougie, especially in patients with anatomically difficult or otherwise obstructed airways. The BEAM study cites a success rate in these patients of 96% with a bougie, compared to 82% without Use a Checklist mnemonic (SOAPME) Suction – On, ready, and within reach Oxygen – Patient is preoxygenated Adjuncts – Oral/nasal adjuncts and BVM ready Positioning - Patient positioned properly; consider obesity, using semi-Fowler/head-up positioning Medications – Rapid sequence intubation (RSI), sedation, vasopressor, and other medications prepared as necessary Equipment – Laryngoscope (blade), tube, bougie/stylet, syringe, scalpel/cric kit, others ready as necessary References Sakles, J.C., Chiu, S., Mosier, J., Walker, C. and Stolz, U…

People in this episode

Guest: Travis Barlock, MD

Topics covered

Keywords

Mentioned in this episode

Organizations: BEAM study, Acad Emerg Med, New Eng

Books & works: The Importance of First Pass Success When Performing Orotracheal Intubation in the Emergency Department

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