Describing the Challenges of Prehospital Rapid Sequence Intubation by Macintosh Blade Video Laryngoscopy Recordings.

Video recordings averaging 35 seconds for first-pass success prehospital RSI with an adjunct give bed-side "definitions of difficulty" of 30 seconds for no glottic view, 45 seconds for no bougie placement, and 60 seconds for no endotracheal tube placement. Awareness of apnea duration can help guide decision making for oxygenation. All emergency intubators need to be cognizant of the need for suctioning. Improving the management of bloodied airways and bougie usage may reduce laryngoscopy duration and be a focus for training. Video screen fogging and missed recordings from some patients may be something manufacturers can address in the future.