Last Updated on August 19, 2026
“Intubation is not just about inserting an ET tube. You must know how to prepare the patient, recognize difficult
airway
Airway Management Related Posts
• Preparation
• Pre-Oxygenation
• Pre-Medication
• Paralysis with Induction
• Positioning
• Placement with Proof
• Post-Intubation Management
Introduction
• Also known as crash induction
• A special process for endotracheal intubation that is used when patient is at high risk of pulmonary aspiration
P1 — Preparation
Mnemonic: SOAP ME • Airway adjunct (oropharyngeal / nasopharyngeal airway) Airway Management Related Posts e.g. fentanyl, midazolam, rocuronium, midamorphine (post intubation sedation) Ideally 2 large bore branula • Vital signs monitor
• Suction device, Stethoscope, Syringe (10 mL)
• Oxygen: Bag-valve mask (±HFM) attached to 15L/min of O2
•
Airway equipment
• Laryngoscope
• ET tube (adult male: 7.5 – 8.0 mm; adult female 7 – 7.5 mm)
• Stylet
• Bougie
• LMA
• Surgical airway kit
• Pharmacy (
medication
•
Monitoring Equipment
• Cardiac monitor
Keywords
Laryngoscope, Bougie×Laryngoscope📑 Function
• To facilitate visualization of upper airway to assist intubation📑 Standard laryngoscope
• Macintosh: curved blade (tip is placed in the vallecula and indirectly expose the larynx when it's lifted)• Miller: straight blade (tip passes posterior to epiglottis and directly expose larynx when it's lifted), e.g. for use in neonatal resuscitation
📑 Video laryngoscope
• Allows direct visualization of vocal cord
• Types e.g. C-Mac, Glidescope×BougieBougie
• A thin plastic rod that is passed into the trachea, over which the endotracheal tube is inserted; especially used for difficult airways
• It's like a 'guide-wire', but for intubation
P2 — Pre-Oxygenation
A process of
denitrogenation
Nitrogen washout with 100% O2, to replace 80% of nitrogen in room air with oxygen
Purpose: to establish O2 reservoir within lungs
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💡 If patient is breathing spontaneously (e.g. prior to administration of muscle relaxant), use high-flow mask
💡 In a spontaneously breathing patient, bag-valve mask is unable to deliver 100% O2
P3 — Pre-Medication
• Given
3 minutes
However, this does not mean that we have to wait for 3 minutes! Wait for about 1 minute (i.e. onset of fentanyl), then proceed with paralysis and induction
Related Posts
• Fentanyl×FentanylFentanyl: https://www.myhouseman.my/fentanyl/
P4 — Paralysis with Induction
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P5 – Positioning
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P6 – Placement with Proof
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P7 – Post-Intubation Management
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Others
Common medications dose:
Further Reading
- Rapid Sequence Intubation (RSI) – Mnemonic Approach, EPOMEDICINE
Take Home Message