John C Sakles

Interests

Teaching

Emergency Airway Management

Research

Emergency Airway Management

Courses

No activities entered.

Scholarly Contributions

Books

• Brown, C., Sakles, J. C., Mick, N., Mosier, J., & Braude, D. (2023). The Walls Manual of Emergency Airway Management. LWW.
• Brown, C. A., Sakles, J. C., & Mick, N. W. (2017). Walls Manual of Emergency Airway Management (Associate Editor). Wolters Kluwer.
• Berkow, L. C., & Sakles, J. C. (2016). Cases in Emergency Airway Management (Co-editor). Cambridge University Press.

Chapters

• Sakles, J. C. (2023). Emergency Cricothyrotomy. In UpToDate(pp Online). Wolters Kluwer.
  More info

  Annually updated international online resource for practicing clinician
• Sakles, J. C., & Brown, C. A. (2023). Rapid Sequence Intubation for Adults Outside the Operating Room. In UpToDate(pp Online). Wolters Kluwer.
  More info

  Annually updated international online resource for practicing clinicians
• Sakles, J. C., & Murphy, M. F. (2023). Airway Management in the Emergency Department. In Hung's Management of the Difficult and Failed Airway. McGraw Hill.
• Driver, B., & Sakles, J. C. (2023). Video Laryngoscopy. In Walls Manual of Emergency Airway Management. LWW.
• Sakles, J. C. (2022). Emergency Cricothyrotomy. In UpToDate(pp Online). Wolters Kluwer.
• Sakles, J. C., & Bair, A. E. (2023). The Unstable Patient: Cardiopulmonary Optimization for Emergency Airway Management. In Walls Manual of Emergency Airway Management. LWW.
• Sakles, J. C., & Brown, C. A. (2022). Rapid Sequence Intubation for Adults Outside the Operating Room. In UpToDate(pp Online). Wolters Kluwer.
• Sakles, J. C. (2021). Emergency Cricthyrotomy. In UpToDate(pp Online). Wolters Kluwer.
• Sakles, J. C., & Brown, C. A. (2021). Rapid Sequence Intubation for Adults Outside the Operating Room. In UpToDate(pp Online). Wolters Kluwer.
• Sakles, J. C. (2020). Emergency Cricthyrotomy. In UpToDate(pp Online). Wolters Kluwer.
• Sakles, J. C., & Brown, C. A. (2020). Rapid Sequence Intubation for Adults Outside the Operating Room. In UpToDate(pp Online). Wolters Kluwer.
• Sakles, J. C., & Brown, C. A. (2019). Rapid Sequence Intubation for Adults Outside the Operating Room. In UpToDate(pp Online). Wolters Kluwer.
• Braude, D. A., & Sakles, J. C. (2017). Prehospital Airway Management. In Hagbergs and Benumof's Airway Management. Elsevier.
• Mosier, J. M., Heffner, A. C., & Sakles, J. C. (2017). The Unstable Patient: Cardiopulmonary Optimization for Emergency Airway Management. In Walls Manual of Emergency Airway Management. LWW.
• Sakles, J. C. (2017). Intubating the Combative Trauma Patient in the Emergency Department. In Clinical Airway Management. Cambridge University Press.
• Sakles, J. C., & Bair, A. E. (2017). Videolaryngoscopy. In Walls Manual of Emergency Airway Management. LWW.
• Sakles, J. C., & Brown, C. A. (2017). Rapid Sequence Intubation for Adults Outside the Operating Room. In UpToDate(pp Online). Wolters Kluwer.
• Sakles, J. C., & Murphy, M. F. (2017). Airway Management in the Emergency Department. In Management of the Difficult and Failed Airway. McGraw Hill.

Journals/Publications

• Pacheco, G. S., Leetch, A. N., Patanwala, A. E., Hurst, N. B., Mendelson, J. S., & Sakles, J. C. (2023). The pediatric rigid stylet improves first pass success compared to the standard malleable stylet and tracheal tube introducer in a simulated pediatric emergency intubation. Pediatric Emergency Care, 39(6), 423-427.
• Sakles, J. C., Ross, C., & Kovacs, G. (2023). Preventing unrecognized esophageal intubation in the emergency department. Journal of the American College of Emergency Medicine Open, 4(3), electronic.
• Chrimes, N., Higgs, A., Carin, H., Baker, P., Cooper, R., Greif, R., George, K., Law, J. A., Marshall, S., Myatra, S., O'Sullivan, E., Rosenblatt, W., Ross, C., Sakles, J. C., & Sorbello, M. (2022). Preventing unrecognised oesophageal intubation: a consensus guideline from the Project for Universal Management of Airways and international airway societies. Anaesthesia.
• Pacheco, G., Patanwala, A. E., Leetch, A. N., Mendelson, J. S., Hurst, N. B., & Sakles, J. C. (2022). Intubation During Pediatric Cardiac Arrest in the Emergency Department Is Associated With Reduced First-Pass Success. Pediatric Emergency Care.
• West, J., Levine, R., Raggi, J., Nguyen, D., Oliver, M., Caputo, N., & Sakles, J. C. (2022). Time to Renitrogenation After Maximal Denitrogenation in Healthy Volunteers in the Supine and Sitting Positions. West J Emerg Med, 926-930.
• Kornas, R. L., Owyang, C. G., Sakles, J. C., Mosier, J. M., & Foley, L. J. (2021). Evaluation and Management of the Physiologically Difficult Airway: Consensus Recommendations from Society for Airway Management. Anesth Analg, 132(2), 395-405.
• Pacheco, G., Hurst, N. B., Patanwala, A., Hypes, C., Mosier, J. M., & Sakles, J. C. (2021). First Pass Success Without Adverse Events is Reduced Equally with Anatomically Difficult Airways and Physiologically Difficult Airways. Western Journal of Emergency Medicine.
• Pacheco, G., Patanwala, A. E., Mendelson, J. S., & Sakles, J. C. (2021). Clinical Experience With the C-MAC and GlideScope in a Pediatric Emergency Department Over a 10-Year Period. Pediatric Emergency Care, Dec 1;37(12):e1098-e1103.
• Sheila, M. N., Oriol, R., & Sakles, J. C. (2021). Maximizing first pass success when intubating the critically ill patient: use a stylet!. Intensive Care Med, 47(6), 695-697.
• Adhikari, S., Situ-LaCasse, E., Acuña, J., Irving, S., Weaver, C., Samsel, K., Biffar, D., Motlagh, M., & Sakles, J. (2020). Integration of Pre-intubation Ultrasound into Airway Management Course: A Novel Training Program. Indian J Crit Care Med, 24(3), 179-183.
• Chrimes, N., Higgs, A., & Sakles, J. C. (2020). Welcome to the era of universal airway management. Anaesthesia, 75(6), 711-715.
• Chrimes, N., Higgs, A., Law, J. A., Baker, P. A., Cooper, R. M., Grief, R., Kovacs, G., Myatra, S. N., O'Sullivan, E. P., Rosenblatt, W. H., Ross, C. H., Sakles, J. C., Sorbello, M., & Hagberg, C. A. (2020). Project for Universal Management of Airways - part 1: concept and methods.. Anaesthesia, 75(12), 1671-1682.
• Garrett, P. S., Asad, P. E., Jennifer, M. S., & Sakles, J. C. (2020). Clinical Experience With the C-MAC and GlideScope in a Pediatric Emergency Department Over a 10-Year Period. Pediatr Emerg Care, online epub.
• Mosier, J. M., Sakles, J. C., Law, J. A., Brown, C. A., & Brindley, P. G. (2020). Tracheal Intubation in the Critically Ill. Where We Came from and Where We Should Go. Am J Respir Crit Care Med, 201(7), 775-788.
• Oliver, M., Caputo, N. D., West, J. R., Hackett, R., & Sakles, J. C. (2020). Emergency physician use of end‐tidal oxygen monitoring for rapid sequence intubation. J Am Coll Emerg Physicians Open, 1(5), 706-713.
• Sakles, J. C. (2020). Awake Intubation in the Emergency Department. Society for Airway Management Airway Gazette, Fall, 17-19.
• Sakles, J. C., Pacheco, G. S., Kovacs, G., & Mosier, J. M. (2020). The difficult airway refocused. Br J Anaesth, 125(1), e18-e21.
• Caputo, N. D., Oliver, M., West, J. R., Hackett, R., & Sakles, J. C. (2019). Use of End Tidal Oxygen Monitoring to Assess Preoxygenation During Rapid Sequence Intubation in the Emergency Department. Annals of Emergency Medicine, 74(3), 410-415.
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  Preoxygenation is important to prevent oxygen desaturation during emergency airway management. The purpose of this study is to describe the use of end tidal oxygen (eto) during rapid sequence intubation in the emergency department.
• Pacheco, G. S., Patanwala, A. E., Mendelson, J. S., & Sakles, J. C. (2019). Clinical Experience With the C-MAC and GlideScope in a Pediatric Emergency Department Over a 10-Year Period. Pediatric Emergency Care.
  More info

  There is little literature describing the performance of video laryngoscopes for the intubation of pediatric patients in the emergency department (ED). The purpose of this study is to report our experience with direct laryngoscopy (DL), the C-MAC (CMAC), and the GlideScope (GVL) over a 10-year period in an urban academic pediatric ED.
• Sakles, J. C., Augustinovich, C. C., Patanwala, A. E., Pacheco, G. S., & Mosier, J. M. (2019). Improvement in the Safety of Rapid Sequence Intubation in the Emergency Department with the Use of an Airway Continuous Quality Improvement Program. The Western Journal of Emergency Medicine, 20(4), 610-618.
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  Airway management in the critically ill is associated with a high prevalence of failed first attempts and adverse events which negatively impacts patient care. The purpose of this investigation is to describe an airway continuous quality improvement (CQI) program and its effect on the safety of rapid sequence intubation (RSI) in the emergency department (ED) over a 10-year period.
• Hughes, K. E., Biffar, D., Ahanonu, E. O., Cahir, T. M., Hamilton, A., & Sakles, J. C. (2018). Evaluation of an Innovative Bleeding Cricothyrotomy Model. Cureus, 10(9), e3327.
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  Objectives Emergency medicine (EM) residents are required to perform a cricothyrotomy during training as per the Accreditation Council for Graduate Medical Education (ACGME) guidelines. Cricothyrotomy is a rare procedure, comprising 0.45% of emergency department airway management procedures. Procedural competence in utilizing a realistic trainer is of utmost importance. We have developed a cricothyrotomy trainer using a fused deposition modeling (FDM) three-dimensional (3D) printer and innovative bleeding tissue to enhance fidelity. We aim to evaluate the trainer's realism. Methods Implementation occurred during a difficult airway educational lab for EM residents in April 2018. Participants completed anonymous written surveys after performing a cricothyrotomy on the trainer. The survey evaluated the realism of the trainer and compared it to other available models by utilizing five-point visual analog scales (VAS). The participants rated their comfort level in performing the procedure pre- and post-educational lab on a five-point VAS. Demographic data included postgraduate year, prior clinical cricothyrotomy experience as a primary operator versus as an assistant, and previous trainer experience. The survey included open-response suggestions for trainer improvement.  Results Forty-three EM residents completed the survey (82.7%, 43/52). The mean realism rating of the trainer was 3.81 (95% CI = 3.54-4.1). The participants reported previous training on cadaver (62.8%, 27/43), porcine (46.5%, 20/43), and manikin (67.4%, 29/43) models prior to using this trainer. The bleeding cricothyrotomy trainer was rated higher than other models (4.45, 95% CI = 4.28-4.63). Participants noted improved comfort with performing the cricothyrotomy after the educational lab (average improvement of 1.23±0.75). Participants specifically commented on the realism of the bleeding and skin texture; however, they also recommended a reduction in the size of the cricothyroid membrane space.  Conclusion The innovative bleeding cricothyrotomy trainer has greater fidelity and reported superiority when compared to other commonly used nonbleeding models. This trainer provides a more advanced platform to teach an infrequent yet critical procedural skill to emergency medicine residents.
• Hypes, C. D., Sakles, J. C., & Mosier, J. M. (2017). Reply: Did Video Kill the Direct Laryngoscopy Star? Not Yet!. Annals of the American Thoracic Society, 14(4), 610-611.
• Kilber, E., Jarrell, D. H., Sakles, J. C., Edwards, C. J., & Patanwala, A. E. (2017). Analgosedative interventions after rapid sequence intubation with rocuronium in the emergency department. American Journal of Emergency Medicine.
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  The use of etomidate and rocuronium for rapid sequence intubation (RSI) results in a duration of paralysis that exceeds the duration of sedation. The primary objective of this study was to compare the number of analgosedative (AGS) interventions early versus late post-RSI, with this drug combination. The secondary objective was to descriptively assess time to first AGS intervention.
• Patanwala, A. E., & Sakles, J. C. (2017). Effect of patient weight on first pass success and neuromuscular blocking agent dosing for rapid sequence intubation in the emergency department. Emergency Medicine Journal, 34(11), 739-743.
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  The primary objective of this study was to determine the association between patient weight and first pass success (FPS) during rapid sequence intubation (RSI) in the ED. The secondary objective was to evaluate the association between patient weight and neuromuscular blocking agent (NMBA) dosing.
• Sakles, J. C. (2017). Improving the Safety of Rapid Sequence Intubation in the Emergency Department. Annals of Emergency Medicine, 69(1), 7-9.
• Sakles, J. C. (2017). Maintenance of Oxygenation During Rapid Sequence Intubation in the Emergency Department. Academic Emergency Medicine, 24(11), 1395-1404.
• Sakles, J. C. (2017). Operator Beware: Know the Type of Video Laryngoscope Blade You Are Using. Journal of Emergency Medicine.
• Sakles, J. C., Corn, G. J., Hollinger, P., Arcaris, B., Patanwala, A. E., & Mosier, J. M. (2017). The Impact of a Soiled Airway on Intubation Success in the Emergency Department when using the GlideScope or the Direct Laryngoscope. Academic Emergency Medicine.
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  To determine the impact of a soiled airway on first pass success when using the GlideScope video laryngoscope or the direct laryngoscope for intubation in the emergency department.
• Sakles, J. C., Douglas, M. J., Hypes, C. D., Patanwala, A. E., & Mosier, J. M. (2017). Management of Patients with Predicted Difficult Airways in an Academic Emergency Department. Journal of Emergency Medicine, 53(2), 163-171.
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  Patients with difficult airways are sometimes encountered in the emergency department (ED), however, there is a little data available regarding their management.
• Hypes, C. D., Sakles, J. C., & Mosier, J. M. (2016). Reply: Video Laryngoscopy: Take It to the Floor. Annals of the American Thoracic Society, 13(7), 1193-4.
• Hypes, C. D., Stolz, U., Sakles, J. C., Joshi, R. R., Natt, B., Malo, J., Bloom, J. W., & Mosier, J. M. (2016). Video Laryngoscopy Improves Odds of First Attempt Success at Intubation in the ICU: A Propensity-Matched Analysis. Annals of the American Thoracic Society, 13(3), 382-390.
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  Urgent tracheal intubation is performed frequently in intensive care units and incurs higher risk than when intubation is performed under more controlled circumstances. Video laryngoscopy may improve the chances of successful tracheal intubation on the first attempt; however existing comparative data on outcomes are limited.
• Hypes, C., Sakles, J., Joshi, R., Greenberg, J., Natt, B., Malo, J., Bloom, J., Chopra, H., & Mosier, J. (2016). Failure to achieve first attempt success at intubation using video laryngoscopy is associated with increased complications. Internal and Emergency Medicine.
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  The purpose of this investigation was to investigate the association between first attempt success and intubation-related complications in the Intensive Care Unit after the widespread adoption of video laryngoscopy. We further sought to characterize and identify the predictors of complications that occur despite first attempt success. This was a prospective observational study of consecutive intubations performed with video laryngoscopy at an academic medical Intensive Care Unit. Operator, procedural, and complication data were collected. Multivariable logistic regression was used to examine the relationship between the intubation attempts and the occurrence of one or more complications. A total of 905 patients were intubated using a video laryngoscope. First attempt success occurred in 739 (81.7 %), whereas >1 attempt was needed in 166 (18.3 %). One or more complications occurred in 146 (19.8 %) of those intubated on the first attempt versus 107 (64.5 %, p 1 attempt is associated with 6.4 (95 % CI 4.4-9.3) times the adjusted odds of at least one complication. Pre-intubation predictors of at least one complication despite first attempt success include vomit or edema in the airway as well as the presence of hypoxemia or hypotension. There are increased odds of complications with even a second attempt at intubation in the Intensive Care Unit. Complications occur frequently despite a successful first attempt, and as such, the goal of airway management should not be simply first attempt success, but instead first attempt success without complications.
• Joshi, R., Hypes, C. D., Greenberg, J., Snyder, L., Malo, J., Bloom, J. W., Chopra, H., Sakles, J. C., & Mosier, J. M. (2016). Difficult Airway Characteristics Associated with First Attempt Failure at Intubation Using Video Laryngoscopy in the Intensive Care Unit. Annals of the American Thoracic Society.
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  Video laryngoscopy has overcome the need to align the anatomic axes to obtain a view of the glottic opening in order to place a tracheal tube. However, despite this advantage, a large number of attempts are unsuccessful. There are no existing data on anatomic characteristics in critically ill patients associated with a failed first attempt at laryngoscopy when using video laryngoscopy.
• Mosier, J. M., Hypes, C. D., & Sakles, J. C. (2016). Understanding preoxygenation and apneic oxygenation during intubation in the critically ill. Intensive Care Medicine.
• Natt, B. S., Malo, J., Hypes, C. D., Sakles, J. C., & Mosier, J. M. (2016). Strategies to improve first attempt success at intubation in critically ill patients. British Journal of Anaesthesia, 117 Suppl 1, i60-i68.
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  Tracheal intubation in critically ill patients is a high-risk procedure. The risk of complications increases with repeated or prolonged attempts, making expedient first attempt success the goal for airway management in these patients. Patient-related factors often make visualization of the airway and placement of the tracheal tube difficult. Physiologic derangements reduce the patient's tolerance for repeated or prolonged attempts at laryngoscopy and, as a result, hypoxaemia and haemodynamic deterioration are common complications. Operator-related factors such as experience, device selection, and pharmacologic choices affect the odds of a successful intubation on the first attempt. This review will discuss the 'difficult airway' in critically ill patients and highlight recent advances in airway management that have been shown to improve first attempt success and decrease adverse events associated with the intubation of critically ill patients.
• Patanwala, A. E., Erstad, B. L., Roe, D. J., & Sakles, J. C. (2016). Succinylcholine Is Associated with Increased Mortality When Used for Rapid Sequence Intubation of Severely Brain Injured Patients in the Emergency Department. Pharmacotherapy, 36(1), 57-63.
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  To compare succinylcholine and rocuronium regarding mortality in patients with traumatic brain injury (TBI) who are intubated in the emergency department (ED).
• Sakles, J. C., & Mosier, J. M. (2016). Reply. Journal of Emergency Medicine, 51(2), 188-9.
• Sakles, J. C., Mosier, J. M., Patanwala, A. E., & Dicken, J. M. (2016). Apneic oxygenation is associated with a reduction in the incidence of hypoxemia during the RSI of patients with intracranial hemorrhage in the emergency department. Internal and Emergency Medicine.
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  Critically ill patients undergoing emergent intubation are at risk of oxygen desaturation during the management of their airway. Patients with intracranial hemorrhage (ICH) are particularly susceptible to the detrimental effects of hypoxemia. Apneic oxygenation (AP OX) may be able to reduce the occurrence of oxygen desaturation during the emergent intubation of these patients. We sought to assess the effect AP OX on oxygen desaturation during the rapid sequence intubation (RSI) of patients with ICH in the emergency department (ED). We prospectively collected data on all patients intubated in an urban academic ED over the 2-year period from July 1, 2013 to June 30, 2015. Following each intubation, the operator completed a standardized continuous quality improvement (CQI) data form, which included information on patient, operator and intubation characteristics. Operators recorded data on the use of AP OX, the oxygen flow rate used for AP OX, and the starting and lowest saturations during intubation. Adult patients with ICH who underwent RSI by emergency medicine (EM) residents were included in the analyses. The primary outcome variable was any oxygen saturation
• Sakles, J. C., Mosier, J. M., Patanwala, A. E., Arcaris, B., & Dicken, J. M. (2016). First Pass Success without Hypoxemia is Increased with the Use of Apneic Oxygenation During RSI in the Emergency Department. Academic Emergency Medicine.
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  To determine the effect of apneic oxygenation (AP OX) on first pass success without hypoxemia (FPS-H) in adult patients undergoing rapid sequence intubation (RSI) in the emergency department (ED).
• Sakles, J. C., Mosier, J. M., Patanwala, A. E., Arcaris, B., & Dicken, J. M. (2016). The Utility of the C-MAC as a Direct Laryngoscope for Intubation in the Emergency Department. Journal of Emergency Medicine, 51(4), 349-357.
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  Although the C-MAC (Karl Storz, Tuttlingen, Germany) is a video laryngoscope (VL), it can also be used as a direct laryngoscope (DL).
• Gaither, J. B., Stolz, U., Ennis, J., Moiser, J. M., & Sakles, J. C. (2015). Association Between Difficult Airway Predictors and Failed Prehosptial Endotracheal Intubation. Air Medical Journal, 34(6), 343-7.
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  Difficult airway predictors (DAPs) are associated with failure of endotracheal intubation (ETI) in the emergency department (ED). The purpose of this study was to determine if DAPs are associated with failure of prehospital ETI.
• Michailidou, M., O'Keeffe, T., Mosier, J. M., Friese, R. S., Joseph, B., Rhee, P., & Sakles, J. C. (2015). A comparison of video laryngoscopy to direct laryngoscopy for the emergency intubation of trauma patients. World Journal of Surgery, 39(3), 782-8.
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  Direct laryngoscopy (DL) has long been the gold standard for tracheal intubation in emergency and trauma patients. Video laryngoscopy (VL) is increasingly used in many settings and the purpose of this study was to compare its effectiveness to direct laryngoscopy in trauma patients. Our hypothesis was that the success rate of VL would be higher than that of DL.
• Mosier, J. M., Joshi, R., Hypes, C., Pacheco, G., Valenzuela, T., & Sakles, J. C. (2015). The Physiologically Difficult Airway. Western Journal of Emergency Medicine, 16(7), 1109-17.
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  Airway management in critically ill patients involves the identification and management of the potentially difficult airway in order to avoid untoward complications. This focus on difficult airway management has traditionally referred to identifying anatomic characteristics of the patient that make either visualizing the glottic opening or placement of the tracheal tube through the vocal cords difficult. This paper will describe the physiologically difficult airway, in which physiologic derangements of the patient increase the risk of cardiovascular collapse from airway management. The four physiologically difficult airways described include hypoxemia, hypotension, severe metabolic acidosis, and right ventricular failure. The emergency physician should account for these physiologic derangements with airway management in critically ill patients regardless of the predicted anatomic difficulty of the intubation.
• Mosier, J. M., Malo, J., Sakles, J. C., Hypes, C. D., Natt, B., Snyder, L., Knepler, J., Bloom, J. W., Joshi, R., & Knox, K. (2015). The impact of a comprehensive airway management training program for pulmonary and critical care medicine fellows. A three-year experience. Annals of the American Thoracic Society, 12(4), 539-48.
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  Airway management in the intensive care unit (ICU) is challenging, as many patients have limited physiologic reserve and are at risk for clinical deterioration if the airway is not quickly secured. In academic medical centers, ICU intubations are often performed by trainees, making airway management education paramount for pulmonary and critical care trainees.
• Mosier, J. M., Sakles, J. C., Stolz, U., Hypes, C. D., Chopra, H., Malo, J., & Bloom, J. W. (2015). Neuromuscular blockade improves first-attempt success for intubation in the intensive care unit. A propensity matched analysis. Annals of the American Thoracic Society, 12(5), 734-41.
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  The use of neuromuscular blocking agents (NMBAs) has been shown to be valuable in improving successful tracheal intubation in the operating room and emergency department. However, data on NMBA use in critically ill intensive care unit (ICU) patients are lacking. Furthermore, there are no data on NMBA use with video laryngoscopy.
• Mosier, J. M., Sakles, J. C., Whitmore, S. P., Hypes, C. D., Hallett, D. K., Hawbaker, K. E., Snyder, L. S., & Bloom, J. W. (2015). Failed noninvasive positive-pressure ventilation is associated with an increased risk of intubation-related complications. Annals of Intensive Care, 5, 4.
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  Noninvasive positive-pressure ventilation (NIPPV) use has increased in the treatment of patients with respiratory failure. However, despite decreasing the need for intubation in some patients, there are no data regarding the risk of intubation-related complications associated with delayed intubation in adult patients who fail NIPPV. The objective of this study is to evaluate the odds of a composite complication of intubation following failed NIPPV compared to patients intubated primarily in the medical intensive care unit (ICU).
• Prescher, H., Grover, E., Mosier, J. M., Stolz, U., Biffar, D. E., Hamilton, A. J., & Sakles, J. C. (2015). Telepresent intubation supervision is as effective as in-person supervision of procedurally naive operators. Telemedicine Journal and e-health, 21(3), 170-5.
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  Telepresence is emerging in clinical and educational settings as a potential modality to provide expert guidance during remote airway management. This study aimed to compare the effectiveness of telepresent versus in-person supervision of tracheal intubation.
• Sakles, J. C., Javedani, P. P., Chase, E., Garst-Orozco, J., Guillen-Rodriguez, J. M., & Stolz, U. (2015). The use of a video laryngoscope by emergency medicine residents is associated with a reduction in esophageal intubations in the emergency department. Academic Emergency Medicine, 22(6), 700-7.
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  The purpose of this investigation was to compare the incidence of esophageal intubations (EIs) when emergency medicine (EM) residents used a direct laryngoscope (DL) versus a video laryngoscope (VL) for intubation attempts in the emergency department (ED).
• Sakles, J. C., Mosier, J. M., Patanwala, A. E., Dicken, J. M., Kalin, L., & Javedani, P. P. (2015). The C-MAC® video laryngoscope is superior to the direct laryngoscope for the rescue of failed first-attempt intubations in the emergency department. Journal of Emergency Medicine, 48(3), 280-6.
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  To compare the effectiveness of the C-MAC® video laryngoscope (CMAC) to the direct laryngoscope (DL) when used to rescue a failed first attempt intubation in the emergency department (ED).
• Sakles, J. C., Mosier, J., Patanwala, A. E., & Dicken, J. (2014). Improvement in GlideScope® Video Laryngoscopy performance over a seven-year period in an academic emergency department. Internal and emergency medicine, 9(7), 789-94.
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  To evaluate the outcomes in first pass success (FPS) of GlideScope (GVL) intubations over a seven-year period in an academic ED. Data were prospectively collected on all patients intubated in an academic ED with a level 1 trauma center over the seven-year period from July 1, 2007 to June 30, 2014. Following each intubation, the operator completed a standardized data collection form that included information on patient, operator and procedure characteristics. The primary outcome was first pass success, defined as successful intubation with a single laryngoscope blade insertion. The secondary outcome was the Cormack-Lehane (CL) view of the airway. To adjust for important confounders, a logistic regression model was used to determine the association between academic year and first pass success. In the first year of the study, the first pass success with the GVL was 75.6% (68/90; 95% CI 65.4-84.0%) and the percentage of patients with CL I/II views was 95.6% (86/90; 95% CI 89.0-98.8%). By the seventh year of the study, the first pass success with the GVL increased to 92.1% (128/139; 95% CI 86.3-96.0%) and the percentage of patients with CL I/II views was 94.2% (131/139; 95% CI 89.0-97.5%). In the logistic regression model, first pass success improved during the seven-year period (aOR 3.1; 95% CI 1.3-7.1; p = 0.008). Over the seven-year period, there was significant improvement in the first pass success of the GVL, without any change in the Cormack-Lehane view, suggesting that there was improvement in the skill of tube delivery with use of the GVL over time.
• Sakles, J. C., Mosier, J., Patanwala, A. E., & Dicken, J. (2014). Learning curves for direct laryngoscopy and GlideScope® video laryngoscopy in an emergency medicine residency. Western Journal of Emergency Medicine, 15(7), 930-7.
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  Our objective is to evaluate the resident learning curves for direct laryngoscopy (DL) and GlideScope® video laryngoscopy (GVL) over the course of an emergency medicine (EM) residency training program.

Presentations

• Oliver, M., Caputo, N., West, J., Hackett, R., & Sakles, J. C. (2019, October). Impact of End-Tidal Oxygen Monitoring on the Efficacy of Preoxygenation During Rapid Sequence Intubation in the Emergency Department. American College of Emergency Medicine Research Forum. Denver, CO: American College of Emergency Medicine.
• Caputo, N., Oliver, M., West, J., Hackett, R., & Sakles, J. C. (2018, May). The Efficacy of Current Preoxygenation Strategies During Rapid Sequence Intubation in the Emergency Department. American College of Emergency Medicine Research Forum. San Diego, CA: American College of Emergency Medicine.
• Olvera, D., Patanwala, A., Wolfe, A., & Sakles, J. C. (2018, May). The Importance of First Pass Success in Prehospital Intubation. Society for Academic Emergency Medicine Annual Meeting. Indianapolis, IA: Society for Academic Emergency Medicine.
• Pacheco, G., Hypes, C., Mosier, J. M., & Sakles, J. C. (2018, May). Video Laryngoscopy Improves First Pass Success in Pediatric Intubations in the Emergency Department. Society for Academic Emergency Medicine Annual Meeting. Indianapolis, IA: Society for Academic Emergency Medicine.
• Sakles, J. C., Augustinovich, C., Hypes, C., Patanwala, A., & Mosier, J. M. (2018, May). Use of an Airway Registry to Improve the Safety of Airway Management in the Emergency Department. Society for Academic Emergency Medicine Annual Meeting. Indianapolis, IA: Society for Academic Emergency Medicine.
• Sakles, J. C., Hughes, K., Hamilton, A. J., Biffar, D., Ahanonu, E., & Cahir, T. (2018, May). Evaluation of an Innovative Bleeding Cricothyrotomy Model. American College of Emergency Medicine Research Forum. San Diego, CA: American College of Emergency Medicine.
• Arcaris, B., Dicken, J. M., Patanwala, A. E., & Sakles, J. C. (2015, Fall). Emergency Medicine Residents Perform Better When Using a Video Enabled Macintosh Blade Compared to a Conventional Macintosh Blade for Emergency Intubations. ACEP Research Forum. Boston: ACEP.
• Chopra, S., Malo, J., Sakles, J. C., Hypes, C., Bloom, J., & Mosier, J. (2015, Winter). Neuromuscular Blockade Improves First Attempt Success for Intubation in the ICU: A Propensity Adjusted Analysis. Society of Critical Care Medicine Annual Congress. Phoenix: Society of Critical Care Medicine.
• Corn, G. J., Hollinger, P., Patanwala, A. E., & Sakles, J. C. (2015, Fall). The Use of a GlideScope Video Laryngoscope is Associated with a Higher First Pass Success than a Direct Laryngoscope in the Presence of a Bloody Airway. ACEP Research Forum. Boston: ACEP.
• Patanwala, A. E., Erstad, B. L., Roe, D., & Sakles, J. C. (2015, October). Succinylcholine is associated with increased mortality when used for rapid sequence intubation of severely head injured patients in the emergency department. ACEP Research Forum. Boston, MA.
• Sakles, J. C., Patanwala, A. E., Mosier, J. M., & Dicken, J. M. (2015, Spring). The Impact of Apneic Oxygenation on Oxygen Desaturation During the Emergency Department Intubation of Patients with Neurologic Injury. SAEM Annual Meeting. San Diego: SAEM.
• Sakles, J. C., Patanwala, A. E., Mosier, J. M., Arcaris, B., & Dicken, J. M. (2015, Fall). First Pass Success of the GlideScope Titanium Mac Video laryngoscope is Higher When Used as a Video Laryngoscope Than When Used as a Direct Laryngoscope for Emergency Intubation. MEMC VIII. Rome, Italy: AAEM.
• Sakles, J. C., Patanwala, A. E., Mosier, J. M., Arcaris, B., & Dicken, J. M. (2015, Fall). The Use of Apneic Oxygenation is Associated with an Increase in First Pass Success in Rapid Sequence Intubations in the Emergency Department. MEMC VIII. Rome, Italy: AAEM.
• Sakles, J. C., Patanwala, A. E., Mosier, J. M., Arcaris, B., & Dicken, J. M. (2015, Winter). Comparison Of The GlideScope Titanium Hyperangulated VL Versus The GlideScope Titanium Macintosh VL For Difficult Intubations In The ED. World Airway Management Meeting. Dublin, Ireland: Difficult Airway Society and Society for Airway Management.
• Sakles, J. C., Patanwala, A. E., Mosier, J. M., Arcaris, B., & Dicken, J. M. (2015, Winter). First Pass Success Without Hypoxemia Is Increased With The Use Of Apneic Oxygenation With RSI In The Emergency Department. World Airway Management Meeting. Dublin, Ireland: Difficult Airway society and Society for Airway Management.
• Sakles, J. C., Patanwala, A. E., Mosier, J. M., Arcaris, B., & Dicken, J. M. (2015, Winter). The Utility Of The C-MAC As A Direct Laryngoscope For Intubation In The Emergency Department. World Airway Management Meeting. Dublin, Ireland: Difficult Airway Society and Society for Airway Management.
• Stea, N., Falvey, D., Stolz, U., & Sakles, J. C. (2013, June). The impact of obesity on the first pass success rate of emergency department intubations. National Society of Academic Emergency Medicine Annual Meeting. Atlanta, GA.
• Stea, N., Falvey, D., Stolz, U., & Sakles, J. C. (2013, June). The impact of obesity on the first pass success rate of emergency department intubations. Western Society of Academic Emergency Medicine Annual Meeting. Long Beach, CA.

Poster Presentations

• Cristan, E., Mosier, J. M., Hypes, C., Greenberg, J., Morrissette, K., Milligan, R., Sakles, J. C., & Malo, J. (2017, Spring). Improvement in tracheal intubation over time with the institution of a quality improvement program. SCCM Annual Congress. Honolulu, HI.
• Greenberg, J., Mosier, J. M., Malo, J., Morrissette, K., Cristan, E., Milligan, R., Sakles, J. C., & Hypes, C. (2017, Spring). Reintubation in the intensive care unit: Is it truly as difficult as assumed?. SCCM Annual Congress. Honolulu, HI.
• Hughes, K., & Sakles, J. C. (2019, January). Evaluation of a Bleeding Cricothyrotomy Trainer. International Meeting for Simulation in Healthcare. San Antonio, TX.
• Olvera, D., Patanwala, A., Wolfe, A., & Sakles, J. C. (2019, November). First Pass Success is Important in Prehospital Intubation to Minimize the Risk of Physiologic Deterioration. World Airway Management Meeting (WAMM). Amsterdam, The Netherlands: Society For Airway Management, The Difficult Airway Society, European Society for Airway Management.
• Pacheco, G., Hypes, C., Mosier, J. M., Patanwala, A., Sakles, J. C., & Hurst, N. B. (2019, November). Adverse Events in Patients with Physiologically Difficult and Anatomically Difficult Airways in the Emergency Department.. World Airway Management Meeting. Amsterdam, NE: SAM, EAMS.
• Pacheco, G., Mendelson, J., Fisher, R., & Sakles, J. C. (2019, October). Pediatric Cardiac Arrest is Associated With Increased Number of Intubation Attempts in the Emergency Department. American College of Emergency Medicine Research Forum. Denver, CO: American College of Emergency Medicine.
• Pacheco, G., Mosier, J. M., Hypes, C., & Sakles, J. C. (2019, November). The Physiologically Difficult Airway is Associated with as Many Adverse Events as the Anatomically Difficult Airway in the Emergency Department. World Airway Management Meeting (WAMM). Amsterdam: Society For Airway Management.
• Sakles, J. C., Caputo, N., West, J., Hackett, R., & Oliver, M. (2019, November). Impact of ETO2 Monitoring on the Prevalence of Oxygen Desaturation during RSI in the ED. World Airway Management Meeting (WAMM). Amsterdam, The Netherlands: Society For Airway Management, The Difficult Airway Society, European Society for Airway Management.
• Pacheco, G., & Sakles, J. C. (2018, September). Video Laryngoscopy Does Not Reduce the Rate of First Pass Success Without Adverse Events (FPS-AE) in Pediatric Emergency Airway Management. Society for Airway Management Annual Meeting. Chicago, IL: Society for Airway Management.
• Augustinovich, C., Hypes, C., Patanwala, A. E., Mosier, J. M., & Sakles, J. C. (2017, September). Improvement in the Quality and Safety of Airway Management in the Emergency Department Over a 10-Year Period with the Use of an Airway CQI Program. Society for Airway Management Annual Meeting. Newport Beach, CA.
• Douglas, M., Mosier, J. M., Patanwala, A. E., Sakles, J. C., & Hypes, C. (2017, September). Measuring FeO2 in the Emergency Department to Optimize Preoxygenation During Rapid Sequence Intubation. Society for Airway Management. Newport Beach, CA.: Society for Airway Management.
  More info

  26. Sakles J, Mosier J, Douglas M, Hypes C, Patanwala A; Measuring FeO2 in the Emergency Department to Optimize Preoxygenation During Rapid Sequence Intubation [Poster]; Society for Airway Management; September 2017; Newport Beach, CA.
• Greenberg, J., Mosier, J. M., Joshi, R., Bloom, J. W., Malo, J., Sakles, J. C., & Hypes, C. (2016, Spring). First attempt success at intubation is associated with a lower odds of adverse events in the ICU. Society For Academic Emergency Medicine. New Orleans, LA.
• Hypes, C., Mosier, J. M., Patanwala, A. E., & Sakles, J. C. (2017, May). The Unanticipated Difficult Airway During Emergency Tracheal Intubation. SAEM Annual Meeting. Orlando, FL.
• Hypes, C., Sakles, J. C., Malo, J., Mosier, J. M., Cristan, E., Milligan, R., & Morrissette, K. (2017, February). Improvement in tracheal intubation over time with the institution of a quality improvement program [Poster]. Society of Critical Care Medicine Annual Congress. Honolulu, HI.: Society of Critical Care Medicine.
• Hypes, C., Sakles, J. C., Malo, J., Mosier, J. M., Jeremy, G., Morrissette, K., Cristan, E., & Milligan, R. (2017, Feb). Re-intubation in the Intensive Care Unit: Is it Truly as Difficult as Assumed? [Poster]. Society of Critical Care Medicine Annual Congress. Honolulu, HI.: Society of Critical Care Medicine.
  More info

  23. Greenberg J, Mosier J, Malo J, Morrissette K, Cristan E, Milligan R, Sakles J, Hypes C; Re-intubation in the Intensive Care Unit: Is it Truly as Difficult as Assumed? [Poster]; Society of Critical Care Medicine Annual Congress; February 2017; Honolulu, HI.
• Hypes, C., Sakles, J. C., Malo, J., Mosier, J. M., Milligan, R., Cristan, E., Greenberg, J., & Morrissette, K. (2017, Feb). Intubation and First Pass Success, a Comparison of C-MAC and GlideScope in the Intensive Care Unit [Poster]. Society of Critical Care Medicine Annual Congress. Honolulu, HI: Society of Critical Care Medicine.
  More info

  21. Milligan R, Mosier J, Cristan E, Greenberg J, Morrissette K, Sakles J, Malo J, Hypes C; Intubation and First Pass Success, a Comparison of C-MAC and GlideScope in the Intensive Care Unit [Poster]; Society of Critical Care Medicine Annual Congress; February 2017; Honolulu, HI
• Hypes, C., Sakles, J. C., Malo, J., Mosier, J. M., Morrissette, K., Cristan, E., Greenberg, J., & Milligan, R. (2017, Feb). Flexible Fiberoptic vs Video Larygoscopy: Insights on Difficult Airway Success and Complications [Poster]. Society of Critical Care Medicine Annual Congress. Honolulu, HI.: Society of Critical Care Medicine.
  More info

  20. Morrissette K, Mosier J, Cristan E, Greenberg J, Milligan R, Sakles J, Malo J, Hypes C, Flexible Fiberoptic vs Video Larygoscopy: Insights on Difficult Airway Success and Complications [Poster]; Society of Critical Care Medicine Annual Congress; February 2017; Honolulu, HI.
• Hypes, C., Sakles, J. C., Mosier, J. M., Natt, B., Greenberg, J., Morrissette, K., & Cristan, E. (2017, Feb). Rethinking NIV: when it works, it works. When it doesn't, it really doesn't. Society of Critical Care Medicine Annual Congress. Honolulu, HI.: Society of Critical Care Medicine.
  More info

  22. Greenberg J, Mosier J, Natt B, Morrissette K, Cristan C, Sakles J, Hypes C; Rethinking NIV: when it works, it works. When it doesn't, it really doesn't [Poster]; Society of Critical Care Medicine Annual Congress; February 2017; Honolulu, HI.
• Hypes, C., Sakles, J. C., Mosier, J. M., Patanwala, A., & Douglas, M. (2017, May). The Unanticipated Difficult Airway during Emergency Tracheal Intubation [Poster]. Society for Academic Emergency Medicine Annual Meeting. Orlando, FL: Society for Academic Emergency Medicine.
  More info

  24. Hypes C, Mosier J, Douglas M, Patanwala A, Sakles J; The Unanticipated Difficult Airway during Emergency Tracheal Intubation [Poster]; Society for Academic Emergency Medicine Annual Meeting; May 2017; Orlando FL.
• Hypes, C., Sakles, J. C., Patanwala, A. E., Mosier, J. M., & Douglas, M. (2017, May). The Physiologically Difficult Airway is Associated with a Reduced First Pass Success without Adverse Events During Emergency Department Intubations [Poster]. Society for Academic Emergency Medicine Annual Meeting. Orlando, FL: Society for Academic Emergency Medicine.
  More info

  25. Sakles J, Douglas M, Hypes C, Patanwala A, Mosier J; The Physiologically Difficult Airway is Associated with a Reduced First Pass Success without Adverse Events During Emergency Department Intubations [Poster]; Society for Academic Emergency Medicine Annual Meeting; May 2017; Orlando FL.
• Kilber, E., Jarrell, D., Sakles, J. C., Edwards, C. J., Patanwala, A. E., Kilber, E., Jarrell, D., Sakles, J. C., Edwards, C. J., & Patanwala, A. E. (2017, October). Comparison of Early Versus Late Sedative Interventions After Rapid Sequence Intubation Using Rocuronium in the Emergency Department. American College of Emergency Physicians. Washington, DC.
• Patanwala, A. E., & Sakles, J. C. (2017, May). Succinylcholine Is Underdosed in Super Heavy Patients and Is Associated With a Reduced First Pass Success. SAEM Annual Meeting. Orlando, FL.
• Sakles, J. C., Douglas, M., Hypes, C., Patanwala, A. E., & Mosier, J. M. (2017, May). The Physiologically Difficult Airway is Associated with a Reduced First Pass Success without Adverse Events During Emergency Department Intubations . SAEM Annual Meeting. Orlando, FL.
• Sakles, J. C., Mosier, J. M., Douglas, M., Hypes, C., & Patanwala, A. E. (2017, September). Measuring FeO2 in the Emergency Department to Optimize Preoxygenation During Rapid Sequence Intubation. Society for Airway Management Annual Meeting. Newport Beach, CA.
• Greenberg, J., Mosier, J. M., Joshi, R., Bloom, J. W., Malo, J., Sakles, J. C., & Hypes, C. (2016, Feb). First Attempt Success at Intubation is Associated with a Lower Odds of Adverse Events in the ICU. Society of Critical Care Medicine Annual Congress. Orlando.
• Hypes, C., Sakles, J. C., Nararro, T., Greenberg, J., Natt, B., Chopra, H., & Mosier, J. M. (2016, Sept). Failure to achieve first attempt success is associated with a higher odds of adverse events during intubation in the Intensive Care Unit using a video laryngoscope. Society for Airway Management. Atlanta.
• Johnston, D., Mosier, J. M., Joshi, R., Malo, J., Bloom, J. W., Sakles, J. C., & Hypes, C. (2016, Feb). Reason For Failed Attempts At Laryngoscopy Differs Between Video And Direct Laryngoscopes. Society of Critical Care Medicine Annual Congress. Orlando.
• Nararro, T., Mosier, J. M., Sakles, J. C., Greenberg, J., Natt, B., Chopra, H., & Hypes, C. (2016, Sept). Predictors of complications of Intensive Care Unit airway management despite first attempt success using video laryngoscopy. Society for Airway Management.
  More info

  This submission won the SAM travel award for Dr. Navarro to present it at the conference. I mentored Dr. Navarro in this activity.
• Sakles, J. C., Douglas, M., Hypes, C., Patanwala, A. E., & Mosier, J. M. (2016, September). Incidence, management and outcomes of the difficult airway in the emergency department. Society for Airway Management. Atlanta.
• Joshi, R., Hypes, C. D., Malo, J., Bloom, J. W., Sakles, J. C., & Mosier, J. M. (2016, February). Predictors of difficult intubation when using video laryngoscopy in the ICU. SCCM Annual Conference.
• Kelsey, M., Hypes, C. D., Joshi, R., Malo, J., Bloom, J. W., Sakles, J. C., & Mosier, J. M. (2016, February). Derivation of a bundle to improve first attempt success at intubation in the ICU. SCCM Annual Conferece.
• Sakles, J. C., Patanwala, A., Viscusi, C. D., Bradshaw, H. R., Pacheco, G. S., Sakles, J. C., Patanwala, A., Viscusi, C. D., Bradshaw, H. R., & Pacheco, G. S. (2013, November). Comparison of glidescope videolaryngoscopy to direct laryngoscopy for intubation of pediatric patients in the emergency department. American College of Emergency Physicians.
• Tolby, N. M., & Sakles, J. C. (2002, June). Ability of Emergency Medicine Residents to Use Alternative Optical Airway Devices. Unspecified.

Others

• Sakles, J. C., & Mosier, J. M. (2018, August). Management of the Physiologically Difficult Airway in the Emergency Department. Anesthesiology News.