If intubation fails, what is the best practice to increase your chances of success on the second attempt?

The recommended practice of changing one or more factors after a failed intubation attempt is essential as it addresses the reasons behind the initial failure. Factors can include the patient's positioning, airway anatomy, or technique. By making adjustments—such as altering the patient's head position, using different airway adjuncts, selecting a different size or type of endotracheal tube, or even changing the staff performing the intubation—you can often improve the conditions for a more successful attempt.

This approach rests on the understanding that intubation can be influenced by a variety of elements, and a methodical change can help account for specific challenges encountered during the initial attempt. Focusing solely on factors such as environmental lighting or the size of the tube may not address the root cause of the failure, leaving the same issues unaddressed in the subsequent attempt. Consequently, the option to change factors is a proactive strategy that aims to enhance the likelihood of success in a critical situation.