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Verbalize the out loud prior to performing rapid sequence intubation.
The Bougie
- Ideal for situations when you’re view is suboptimal
- Advance it through the cords and into the trachea BEFORE the endotracheal tube. It will stay in place and guide the tube into position (this is called a Seldinger technique).
Video Laryngoscopy (Glidescope)
- Laryngoscope with a camera at the tip which displays on a screen at bedside
- Ideal for situations when both view and direct access to the cords is suboptimal (c-collar, poor mallampati). Some physicians use this as their primary technique.
- Use it like a camera that you advance into position so you can see the cords. Maneuver the endotracheal tube by watching indirectly on the screen.
Flexible Endoscopy
- It is a flexible stylet that you can control and has a camera at the tip.
- Advances through the cords like a bougie and the (preloaded) endotracheal tube advances over it.
- Can intubate through both the nose or mouth with this
LMA (laryngeal mask airway)
- Placed blindly and sits above the cords, forming a seal.
- Not a “definitive” airway, but can oxygenate and ventilate the patient when in a difficult situation.
Cricothyrotomy
- Immediately perform this step in “can’t intubate can’t oxygenate” situations
- The 3-step EMCrit method is best in my opinion (see link below)
- “Scalpel, Finger, Bougie”