Emergency Medicine Intubation

Explain how adult upper-airway anatomy determines blade movement, glottic exposure, and endotracheal-tube trajectory during laryngoscopy.

Perform a modality-specific assessment of difficulty for laryngoscopy, face-mask ventilation, supraglottic-airway rescue, and emergency front-of-neck access.

Choose among rapid sequence intubation, delayed sequence intubation, and an awake approach for a given adult emergency-airway case.

Select a preoxygenation method based on shunt physiology, oxygen saturation, respiratory effort, and anticipated apnea tolerance.

Position an adult patient and apply apneic oxygenation to maximize safe apnea time.

Evaluate whether preoxygenation is adequate before administering an induction agent.

Identify an adult at high risk of peri-intubation cardiovascular collapse using clinical findings, hemodynamic trends, and shock indices.

Select fluid, blood-product, and vasopressor support appropriate to the patient's shock phenotype before induction.

Modify the airway plan for severe metabolic acidosis, obstructive lung disease, or right-ventricular failure to reduce decompensation during the transition to positive-pressure ventilation.

Select and dose an induction agent according to the patient's hemodynamics, neurologic priorities, and comorbidities.

Select and dose succinylcholine or rocuronium after evaluating contraindications, desired onset, and anticipated duration.

Plan timely post-intubation analgesia and sedation that prevents awareness during ongoing neuromuscular blockade.

Apply direct-laryngoscopy mechanics that optimize tongue displacement, vallecular engagement, and lifting force.

Apply video-laryngoscopy mechanics that optimize camera view while preserving a passable tube trajectory.

Shape and use a stylet or bougie to match the selected device and anticipated tube path.

Use a structured optimization sequence for a poor laryngeal view or failed tube delivery.

Perform airway positioning and laryngoscopy while minimizing cervical-spine movement in a trauma patient.

Select an airway approach for maxillofacial trauma with blood, vomitus, or distorted anatomy.

Adapt the peri-intubation plan for traumatic brain injury to avoid hypoxemia, hypotension, and harmful carbon-dioxide extremes.

Recognize suspected laryngeal or tracheal injury and choose an airway strategy that avoids worsening the injury.

Recognize failed intubation, failed ventilation, and cannot-intubate-cannot-oxygenate states using explicit clinical thresholds.

Design an optimized repeat attempt that changes the operator, device, positioning, adjunct, or approach rather than repeating an unchanged attempt.

Place a supraglottic airway and determine whether it provides effective rescue oxygenation and ventilation.

Perform the scalpel–bougie–tube emergency cricothyrotomy sequence on a task trainer.

Verify tracheal tube placement and appropriate depth using sustained waveform capnography and complementary clinical methods.

Select initial ventilator settings based on the patient's underlying physiology.

Diagnose and treat immediate post-intubation hypoxemia using a structured differential.

Diagnose and treat immediate post-intubation hypotension using a structured differential.