Emergency Medicine Postgraduate Year, Laryngoscopic View, and Endotracheal Tube Placement Success

Prior work has found first-attempt success improves with emergency medicine (EM) postgraduate year (PGY). However, the association between PGY and laryngoscopic view – a key step in successful intubation – is unknown. We examined the relationship among PGY, laryngoscopic view (ie, Cormack–Lehane view), and first-attempt success. We performed a retrospective analysis of the National Emergency Airway Registry, including adult intubations by EM PGY 1 to 4 resident physicians. We used inverse probability weighting with propensity scores to balance confounders. We used weighted regression and model comparison to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CIs) between PGY and Cormack–Lehane view, tested the interaction between PGY and Cormack–Lehane view on first-attempt success, and examined the effect modification of Cormack–Lehane view on the association between PGY and first-attempt success. After exclusions, we included 15,453 first attempts. Compared to PGY 1, the aORs for a higher Cormack–Lehane grade did not differ from PGY 2 (1.01; 95% CI 0.49 to 2.07), PGY 3 (0.92; 0.31 to 2.73), or PGY 4 (0.80; 0.31 to 2.04) groups. The interaction between PGY and Cormack–Lehane view was significant (P-interaction