{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T16:23:57Z","timestamp":1754151837821,"version":"3.41.2"},"reference-count":0,"publisher":"California Digital Library (CDL)","issue":"4","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Western Journal of Emergency Medicine"],"abstract":"<p>Introduction: Upright intubation is essential for managing difficult airways but can be challenging, especially for less experienced clinicians. Face-to-face intubation may lower first-pass success rates due to unfamiliar orientation. New videolaryngoscope devices have the potential to improve intubation success. We aimed to compare first-pass success rates, intubation duration, and glottic view between the right-rear and face-to-face approaches, using channeled videolaryngoscope, hyperangulated videolaryngoscope, and video stylet for upright intubation. Methods: We conducted a cross-over manikin simulation study involving 30 participants\u201419 attending physicians, six residents, and five nurse practitioners\u2014to compare the efficacy of these devices to a standard Macintosh videolaryngoscope, using both right-rear and face-to-face approaches. Results: We used Cox regression analysis to calculate hazard ratios for the following variables: first-pass success rate; intubation time; glottic view quality (Cormack-Lehane grade [C-L]); and percentage of glottis opening score (POGO]. The right-rear approach demonstrated a substantial improvement in first-pass success rates compared to face-to-face, with rates of 93% vs 78% and a hazard ratio of 2.10 (95% confidence interval 1.58-2.80). Additionally, both the video stylet and channeled videolaryngoscope techniques further optimized first-pass success rates and enhanced glottic visualization, achieving a CL grade I view and POGO scores of 100%, even in the inverted face-to-face orientation. These devices outperformed the standard Macintosh and hyperangulated videolaryngoscopes. Conclusion: The right-rear approach was associated with higher first-pass success rates and provided a more familiar orientation for operators during upright intubation. Video stylets and channeled videolaryngoscopes also contributed to improved success rates, shorter intubation times, and better glottic visualization.<\/p>","DOI":"10.5811\/westjem.39983","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T05:33:15Z","timestamp":1752211995000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparative Efficacy of Face-to-Face and Right-Rear Upright Intubation in a Randomized Crossover Manikin Study"],"prefix":"10.5811","volume":"26","author":[{"given":"Cheng-Wei","family":"Tseng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Shiung","family":"Wen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng-Han","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yung-Cheng","family":"Su","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu-Sheng","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsin-Ling","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzu-Yao","family":"Hung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2025,7,10]]},"container-title":["Western Journal of Emergency Medicine"],"original-title":[],"link":[{"URL":"https:\/\/escholarship.org\/content\/qt4348h9nb\/qt4348h9nb.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T07:19:58Z","timestamp":1753082398000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/4348h9nb"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,10]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,7,19]]}},"URL":"https:\/\/doi.org\/10.5811\/westjem.39983","relation":{},"ISSN":["1936-9018"],"issn-type":[{"type":"electronic","value":"1936-9018"}],"subject":[],"published":{"date-parts":[[2025,7,10]]}}}