Mark complete
15–20 min
1. Preparation: build the room
Objective: Create a room where first-pass success and immediate rescue are both possible.
Oxygenation pathway
Suction x2
BVM and rescue ventilation
Positioning/ramp
Primary and backup device
Tube/stylet/bougie
Rescue airway
Practice: Have a learner physically touch each item and verbalize its purpose before starting the scenario.
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Mark complete
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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Mark complete
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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Mark complete
20–30 min
4. Devices: blades, bougie, video, fiberoptic
Objective: Match device selection to anatomy, physiology, operator skill, and rescue 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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Mark complete
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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Mark complete
20–30 min
6. Rescue 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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Mark complete
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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