First-attempt success and associated factors among emergency tracheal intubations in two addis Ababa hospitals

FPS in these Addis Ababa hospitals (Tikur Anbessa Specialized Hospital and Zewditu Memorial Hospital) was 64.3%, a level we consider suboptimal compared with commonly cited benchmarks of ≥ 80%. This is lower than pooled benchmarks reported from large high-income country series (~ 79-84%) but within the range reported in some low- and middle-income settings. Operator experience and airway visualization were the dominant determinants of one-pass success. Given the high immediate complication rate (37.5%), targeted supervised training, anticipation of difficult anatomy, and prioritized expansion of airway adjuncts (e.g., bougie, phased introduction of video laryngoscopy and capnography) should be implemented to improve FPS and reduce harm in resource-limited emergency settings.