Tracheal intubation in the lateral position in emergency medicine: a narrative review and clinical protocol.

Abstract

Background: Tracheal intubation (TI) is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine. Tracheal intubation in the lateral position (TILP) has been utilized in clinical practice, demonstrating potential advantages in specific scenarios, including emergency settings. However, there is a lack of comprehensive reviews and practical protocols on TILP application. To address this gap, we performed a narrative review, and provided evidence-based recommendations to formulate a practice protocol, to assist clinicians to effectively apply TILP.

Methods: We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience. Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus. The practice protocols were formulated as warranted by advancements in medical knowledge, technology, and practice.

Results: This narrative review summarized the current evidence on TILP application, highlighting its safety, efficacy, challenges, and potential complications. In total, 24 recommendations and a clinical protocol for TILP application in emergency patients were established.

Conclusion: TILP is a valuable technique in emergency medicine. We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol. Future studies are needed to evaluate the safety and efficacy of TILP, broaden its scope of application, and explore effective training protocols.