The majority of second intubation attempts were undertaken by emergency consultants and registrars. A change from a non-consultant intubator to a consultant intubator of any specialty for the second attempt and intubation episodes where laryngoscopy was predicted to be non-difficult were associated with a higher success rate at intubation.

Participation in routine collection and monitoring of airway management practices via a Registry may enable the introduction of appropriate improvements in airway procedures and reduce complication rates.

Data were collected from a multicentre airway registry (The Australian and New Zealand Emergency Department Airway Registry).

Of the 762 patients with a failed first intubation attempt, 603 (79.1%) were intubated successfully at the second attempt.

The majority of second attempts were undertaken by emergency consultants (36.8%) and emergency registrars (34.2%).

A change in intubator occurred in 56.5% of intubation episodes and was associated with higher second attempt success.

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