Self-directed learning module
15–20 min
1. Preparation: build the room
Objective: Create a room where first-pass success and immediate backup are both possible.
- Oxygenation pathway
- Suction x2
- BVM and backup ventilation
- Positioning/ramp
- Primary and backup device
- Tube/stylet/bougie
- Backup airway
Practice: Have a learner physically touch each item and verbalize its purpose before starting the scenario.
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Self-directed learning module
10–15 min
2. Timeout: shared mental model
Objective: Make the plan explicit before paralysis removes options.
- Indication
- Physiology risk
- Allergies/contraindications
- Drug plan
- Plan A/B/C
- CICO trigger
- Post-intubation sedation
Practice: Run a 30-second airway timeout aloud using the scripted template on the Step 2 page.
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Self-directed learning module
15 min
3. Oxygenation and preoxygenation
Objective: Choose an oxygenation strategy that matches the patient’s physiology and preserves margin during the attempt.
- Apneic oxygenation
- NIV/BVM pathway
- PEEP and seal
- Denitrogenation time
- Positioning
- Plan B oxygenation
Practice: Compare NRB, nasal cannula, BVM with PEEP, and NIV setups in a skills station.
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Self-directed learning module
20–30 min
4. Devices: blades, bougie, video, fiberoptic
Objective: Match device selection to anatomy, physiology, operator skill, and backup plan.
- Mac vs Miller
- Video laryngoscopy
- Hyperangulated blade mechanics
- Bougie technique
- Fiberoptic pathway
- Device troubleshooting
Practice: Run the same airway model with direct laryngoscopy, standard geometry video, hyperangulated video, and bougie-first approaches.
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Self-directed learning module
20 min
5. Execution: clean, view, landmarks, pass, prove
Objective: Slow down tube passage enough to prevent common view-to-tube errors.
- Clean the view
- Identify landmarks
- Optimize before passage
- Hover and wait
- Manage tracheal ring hang-up
- Prove placement
Practice: Use a laryngoscopy video and pause before tube passage: ask learners to identify the landmarks and next move.
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Self-directed learning module
20–30 min
6. backup and special airways
Objective: Stop repeating the same failed attempt and make the next move meaningfully different.
- Change oxygenation
- Change position
- Change operator/device
- Use bougie/SGA/fiberoptic
- Cricothyrotomy trigger
- Trach emergency actions
Practice: Give the team a failed attempt. Require them to name exactly what changes before attempt two.
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Self-directed learning module
15 min
7. Post-airway: make the tube safe
Objective: Prevent preventable harm after tube placement.
- Sedation/analgesia
- Ventilator setup
- Hemodynamic reassessment
- Tube depth
- CXR/EtCO₂ documentation
- Debrief
Practice: Run a “tube is in” drill: learners must complete post-airway tasks before leaving the room.
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