How many attempts at laryngoscopy are allowed in a failed airway scenario?

In a failed airway scenario, the common guideline in advanced airway management is to limit the number of direct laryngoscopy attempts to a maximum of three. This is based on the understanding that multiple attempts can increase the likelihood of complications, such as trauma to the airway structures, hypoxia due to prolonged attempts, and diminished chance of successful intubation with subsequent tries.

After three attempts, if intubation has not been successful, it is typically recommended to consider alternative methods for securing the airway, such as using a supraglottic airway device or preparing for a surgical airway intervention, depending on the patient's condition. This approach helps to minimize risk while maximizing patient safety in emergency scenarios, aligning with best practices in trauma and emergency medical care.