Pattern Recognition of Airway Management Barriers and Associated Troubleshooting Methods

Video laryngoscopy (VL) has transformed emergency airway management, offering real-time recording and retrospective analysis. Its rapid adoption in medical education is attributed to superior visualization and identification of anatomical structures. Systematically describing barriers to successful intubation may enhance recognition of these challenges, and articulates troubleshooting options. The purpose of this review is to understand these challenges so that they become recognizable as recurrent barriers to successful intubation, which could enhance education, improve patient safety, and augment provider skills.

The review of our extensive video database uncovered recurrent challenges that clinicians often encounter during intubation. These challenges include patterns such as "sundowning," tongue as a fulcrum, use of Macintosh blade as a Miller blade, and additional items.

Many barriers to successful intubation are recurrent, recognizable, and reproducible. Description of these barriers augments understanding and highlights avenues to troubleshoot. Through discussion of these barriers and the associated troubleshooting strategies, this work aims to not only enhance patient safety and improve procedural education but also systematically elevate intubation skills.