{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T04:38:43Z","timestamp":1777091923416,"version":"3.51.4"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T00:00:00Z","timestamp":1729209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Emergency tracheal intubation is associated with a risk of clinical adverse events, including the risk of first\u2010attempt failure. Induction agents usually include a sedative and a neuromuscular blocking agent (i.e., paralytic). Whether the order of administration (i.e., sedative vs. paralytic given first) is associated with first\u2010attempt failure or adverse events is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study analyzed data from a single\u2010center prospective cohort collected from 2021 to 2024 at Hennepin County Medical Center, which included all patients undergoing orotracheal intubation in the emergency department. Patients with no detail on administration sequence order were excluded. A Bayesian logistic regression analysis was used to measure the effect of drug sequence order (sedative first vs. paralytic first). The primary outcome was first\u2010attempt failure. The key secondary outcome was peri\u2010intubation hypoxemia (SpO<jats:sub>2<\/jats:sub>\u2009&lt;\u200990%). We estimated the odds ratio (OR), 95% credible interval (CrI), and the probability that the OR was inferior to 1 (existence of an effect) and inferior to 0.9 (significant effect). Frequentist analysis and reanalysis with various priors were performed as sensitivity analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2216 patients were included for analysis. The most frequently used sedative and paralytic agents were etomidate (88.9%) and rocuronium (77.8%), respectively. The paralytic was given first to 56.6% of the patients. After adjustment for age, sex, body mass index, and sedative and paralytic agents, the OR for a paralytic\u2010first strategy for first\u2010attempt failure was 0.73 (95% CrI 0.46\u20131.02). The probability that the OR was less than 1 was estimated at 95.7% and less than 0.9 at 87.6%. There was a 33.5% and 8.0% probability that administering the paralytic first resulted in an OR &lt;\u20091 and OR &lt;\u20090.9 for the risk of hypoxemia, respectively. Sensitivity analyses were consistent with the main results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this Bayesian analysis a paralytic\u2010first drug sequence was associated with reduced first\u2010attempt failure during emergency tracheal intubation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.15031","type":"journal-article","created":{"date-parts":[[2024,10,19]],"date-time":"2024-10-19T04:14:17Z","timestamp":1729311257000},"page":"123-129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effect of administration sequence of induction agents on first\u2010attempt failure during emergency intubation: A Bayesian analysis of a prospective cohort"],"prefix":"10.1111","volume":"32","author":[{"given":"Pierre","family":"Catoire","sequence":"first","affiliation":[{"name":"Emergency Department, H\u00f4pital Piti\u00e9\u2010Salp\u00eatri\u00e8re Assistance\u2010Publique H\u00f4pitaux de Paris  Paris France"},{"name":"Improving Emergency Care (IMPEC) FHU Sorbonne Universit\u00e9  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7141-0256","authenticated-orcid":false,"given":"Brian","family":"Driver","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Hennepin County Medical Center  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3969-3022","authenticated-orcid":false,"given":"Matthew E.","family":"Prekker","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Hennepin County Medical Center  Minneapolis Minnesota USA"},{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine Hennepin County Medical Center  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0262-3848","authenticated-orcid":false,"given":"Yonathan","family":"Freund","sequence":"additional","affiliation":[{"name":"Emergency Department, H\u00f4pital Piti\u00e9\u2010Salp\u00eatri\u00e8re Assistance\u2010Publique H\u00f4pitaux de Paris  Paris France"},{"name":"Improving Emergency Care (IMPEC) FHU Sorbonne Universit\u00e9  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13851"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2019.4.42343"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/cem.2018.362"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.12815"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2014.10.036"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13723"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0000000000001085"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2022.08.2232"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199805000-00044"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.74593"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.6496"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer058"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15668"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.23550"},{"key":"e_1_2_11_17_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2021"},{"key":"e_1_2_11_18_1","unstructured":"PlummerM.2003 JAGS: a program for analysis of Bayesian Graphical Models using Gibbs sampling. Paper presented at: Proceedings of the 3rd International Workshop on Distributed Statistical Computing (DSC 2003); March 20\u201022 2003;Vienna Austria.https:\/\/www.r\u2010project.org\/conferences\/DSC\u20102003\/Proceedings\/Plummer.pdf"},{"key":"e_1_2_11_19_1","unstructured":"PlummerM.JAGS: Bayesian Graphical Models using MCMC. R package version 4\u201013.2022."},{"issue":"3","key":"e_1_2_11_20_1","first-page":"1","article-title":"Mice: multivariate imputation by chained equations in R","volume":"45","author":"Van Buuren S","year":"2011","journal-title":"J Stat Softw"},{"key":"e_1_2_11_21_1","unstructured":"MeredithM KruschkeJ.HDInterval: highest (posterior) density intervals. R package version 0.2.4.2022."},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03015622"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199008000-00010"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1214\/08-AOAS191"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.15031","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T07:22:03Z","timestamp":1745824923000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.15031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,18]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/acem.15031"],"URL":"https:\/\/doi.org\/10.1111\/acem.15031","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,18]]},"assertion":[{"value":"2024-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}