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Assessment of the Thyromental Height Test as an Effective Airway Evaluation Tool

      Intubation is a critical skill for every emergency medicine resident to learn. Although rates of failed airways are less than 1%
      • Wong E.
      • Ng Y.-Y.
      The difficult airway in the emergency department.
      • Levitan R.M.
      • Everett W.W.
      • Ochroch E.A.
      Limitations of difficult airway prediction in patients intubated in the emergency department.
      • Reed M.J.
      • Dunn M.J.G.
      • McKeown D.W.
      Can an airway assessment score predict difficulty at intubation in the emergency department?.
      and first-pass success in the emergency department (ED) exceeds 84%,
      • Park L.
      • Zeng I.
      • Brainard A.
      Systematic review and meta-analysis of first-pass success rates in emergency department intubation: creating a benchmark for emergency airway care.
      • Fouche P.F.
      • Stein C.
      • Simpson P.
      • et al.
      Nonphysician out-of-hospital rapid sequence intubation success and adverse events: a systematic review and meta-analysis.
      • April M.D.
      • Arana A.
      • Pallin D.J.
      • et al.
      Emergency department intubation success with succinylcholine versus rocuronium: a National Emergency Airway Registry study.
      • Stoecklein H.H.
      • Kelly C.
      • Kaji A.H.
      • et al.
      Multicenter comparison of nonsupine versus supine positioning during intubation in the emergency department: a National Emergency Airway Registry (NEAR) study.
      the consequences of a difficult and failed airway can be catastrophic.
      • Cook T.M.
      • Woodall N.
      • Frerk C.
      Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia.
      In the ED environment, difficult intubations are not rare (2% to 14%
      • Wong E.
      • Ng Y.-Y.
      The difficult airway in the emergency department.
      ,
      • Srivilaithon W.
      • Muengtaweepongsa S.
      • Sittichanbuncha Y.
      • et al.
      Predicting difficult intubation in emergency department by intubation assessment score.
      ) and are more frequently encountered than in elective operative setting intubations, in which 85% of airway research arises.
      • Ahmad I.
      • Onwochei D.N.
      • Muldoon S.
      • et al.
      Airway management research: a systematic review.
      Even if an airway is eventually secured, adverse events increase significantly after one unsuccessful attempt.
      • Sakles J.C.
      • Chiu S.
      • Mosier J.
      • et al.
      The importance of first pass success when performing orotracheal intubation in the emergency department.
      With recent concerns about aerosolization of severe acute respiratory syndrome coronavirus 2 during intubation, maximizing first-pass success is now also a staff safety issue and has affected resident intubation opportunities. Airway difficulty influences the “who, when, where, how, and with what equipment” of airway management, and consequently its prognostication is a source of interest and research.
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