Questions · Difficult Airway Management
8 questions, 0 approved. Approve them one at a time — a quiz shows nothing you have not.
Recall — derived from a kept point
DEVICE showed a large advantage in first-attempt success for video laryngoscopy. What happened to severe complications, and what does the combination of those two results actually mean?
Answer: Severe complications were essentially identical: 21.4% in the video group versus 20.9% in the direct group, an absolute risk difference of 0.5 percentage points with a confidence interval spanning zero. Safety outcomes including oesophageal intubation, dental injury and aspiration were also similar. So the benefit is in getting the tube on the first attempt, not in making the intubation itself safer once things go badly. First-pass success is worth having on its own terms, but the trial does not license a claim that video laryngoscopy prevents peri-intubation deterioration.
A trial can move a process measure convincingly and leave the patient-centred harm unchanged. Both halves belong in the teaching.
Source claim: In DEVICE, severe complications occurred in 151 patients (21.4%) in the video-laryngoscope group and 149 (20.9%) in the direct-laryngoscope group, an absolute risk difference of 0.5 percentage points (95% CI -3.9 to 4.9), with similar safety outcomes including oesophageal intubation, injury to the teeth and aspiration.
DEVICE trial, NEJM 2023
recall · CA-2 · phrased by llm
Who performed the intubations in DEVICE, and why does that detail matter when you generalise the result to your own practice?
Answer: 91.5% of intubations were performed by an emergency medicine resident or a critical care fellow — that is, by operators still in training. The trial was conducted in 17 emergency departments and ICUs among critically ill adults. That makes the finding most directly applicable to trainees intubating critically ill patients in those settings, and it leaves genuinely open how much of the 14-point advantage would persist for an experienced anaesthetist intubating an elective patient in theatre, where baseline first-pass success is already high.
The operator and the setting are part of the result. A large effect measured in training hands may shrink in experienced ones simply because the ceiling is closer.
Source claim: DEVICE was conducted at 17 emergency departments and intensive care units among critically ill adults, and 91.5% of included patients underwent intubation performed by an emergency medicine resident or a critical care fellow.
DEVICE trial, NEJM 2023
recall · CA-2 · phrased by llm
If the primary airway plan fails, activate 'Code D' for help and attempt rescue with any of the three devices (tracheal tube, SGA, or face mask) without hierarchy until SpO2 remains ≥___%.
Answer: 95
If the primary airway plan fails, activate 'Code D' for help and attempt rescue with any of the three devices (tracheal tube, SGA, or face mask) without hierarchy until SpO2 remains ≥95%.
All India Difficult Airway Association 2025 Guidelines for the management of unanticipated difficult airway in adults under general anaesthesia · PMID 41293142
recall · CA-1 · phrased by derived
The point with one number taken out. No model wrote any of this: the stem is the sentence you reviewed, minus a digit, and the paper it came from is named beneath it.
Open prompts
Walk me through your setup for this before we start.
open · CA-1 · phrased by derived
What are you watching on the monitor that would tell you this is going wrong?
open · CA-1 · phrased by derived
What is your first move if it does?
open · CA-1 · phrased by derived
What would you want ready in the room before induction?
open · CA-1 · phrased by derived
Questions only — nothing here asserts anything, which is why a model is allowed to phrase them. Where no model was reachable these are the level defaults.