Post-Airway

Step 4

Confirm the tube, secure it, set the ventilator, start analgesia/sedation, and complete follow-up.

Learning objectives

Confirm ETT with waveform capnography
Secure the tube and place gastric decompression when appropriate
Verbalize and confirm ventilator settings
Start analgesia and sedation
Reassess hemodynamics/oxygenation and complete follow-up

Say aloud

The ETT is confirmed with continuous waveform capnography and secured. OG/NG placement is addressed. Vent settings are verbalized and confirmed. Analgesia and sedation are active. Hemodynamics and oxygenation are reassessed. Blood gas and chest imaging will be obtained when indicated.

Critical actions

Tube confirmation

Confirm ETT with continuous waveform capnography

Secure

Secure ETTOG/NG placement when clinically appropriate

Ventilation

Vent settings verbalized and confirmed

Sedation / analgesia

Analgesia initiatedSedation initiatedReassess hemodynamics and oxygenation

Follow-up

Obtain and review blood gas when indicatedChest X-ray when indicated

Teaching pearl

The airway is not complete at tube passage. Immediate confirmation, analgesia/sedation, ventilator setup, hemodynamic reassessment, and follow-up prevent avoidable post-intubation harm.

Common pitfalls

Relying on auscultation without waveform capnography
Leaving a paralyzed patient without analgesia and sedation
Vent settings not verbalized or reassessed
Post-intubation hypotension or hypoxia ignored
Treating blood gas or chest X-ray as automatic rather than indication- and context-dependent follow-up

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