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BET 3: Do head elevation and neck flexion improve laryngeal view and the likelihood of successful intubation

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Report by: Andrew Rusk, Emergency Medicine Resident

Checked by: Laith Sultan, Senior Emergency Trainee

Institution: Grand Rapids Medical Education and Research Centre and Manchester Royal Infirmary, UK

Three-part question

In (patients needing endo-tracheal intubation) does (head elevation and neck flexion) (improve laryngeal view and the likelihood of successful intubation)?

Clinical scenario

A short, obese female with pneumonia enters the emergency department. She is tachypnoeic, febrile, and labouring intensely to breath. She has an oxygen saturation of 76% on room air and becomes decreasingly responsive in front of you. You believe her declining respiratory condition merits intubation. You anticipate a difficult intubation and wonder if any simple manoeuvres might be of some help. You have heard that elevating the head and flexing the neck (sniffing the air position) gives …

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