Intubation: Preparation & Technique

Procedures & Monitoring · ICU Decoded chapter 75 · Locked — free with a referral

By Dr Javed Akhtar · Last reviewed 3 October 2026

Cited to Difficult Airway Society 2025.

Key points

Prepare with SOAP-ME (suction, O₂, airway gear, pharm, monitoring equipment) and preoxygenate 3–5 min.
RSI: ketamine/etomidate plus rocuronium 1.2 mg/kg for induction; cricoid pressure is controversial; have plan B (LMA, bougie, video) ready.
Confirm with ETCO₂ waveform, bilateral sounds, CXR depth 21–23 cm.
Post-intubation hypotension: preload, pressors ready, check for auto-PEEP.
DAS 2025: videolaryngoscopy for the first attempt and apnoeic oxygenation with HFNO 15 L/min.

Investigations

First tests: Continuous waveform capnography, Ventilator and bedside assessment.

Only if indicated: Arterial blood gas, Chest X-ray.

Repeat monitoring: Ventilator and bedside assessment.

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