Approach
• Assess need for intubation
• Anticipated need for airway management in pts at risk for deterioration
• Assess difficulty of intubation early
• In pts w/ acute respiratory failure, BVM ventilation or noninvasive positive pressure ventilation (NiPPV) can be a bridge but not a substitute to intubation
• Choose appropriate intubation algorithm
• Choose appropriate intubation tool
• VL: 1st choice, if available; failure rate is lower than w/ standard DL
• DL: Most commonly used (Mac or Miller blade)
• Awake sedated airway eval: Injection, inhalation, or topical application of local anesthetic then intubation via, VL or fiber optic → requires cooperative pt, noncrash airway
Pearls
• Have rescue devices at the ready: EGD, cricothyrotomy kit
• Good BVM technique saves lives