| Knowledge |
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States Relative Contraindications of procedure.
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| Preparation |
| Clinical Standards for Procedures and Interventions. |
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| Confirms the indication, evaluates anatomical and physiological difficulty, identifies aspiration and hemodynamic risk, and establishes Plan A through Plan D with explicit failure and rescue criteria. |
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| Calls for appropriate assistance, assigns roles, completes an airway checklist, and confirms monitoring, intravenous access, medications, and post-intubation sedation and ventilation plans. |
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| Prepares and function-checks direct and video laryngoscopy as appropriate, endotracheal tubes, stylet or bougie, suction, bag-mask device, supraglottic airway, waveform capnography, tube securement, and emergency front-of-neck equipment. |
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| Optimizes patient position, oxygenation and hemodynamics and provides preoxygenation, continuous oxygen delivery, and apneic oxygenation when appropriate. |
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| Implementation |
| Administers induction, analgesic, and neuromuscular-blocking medications only under an authorized protocol with immediate rescue capability. |
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| Performs laryngoscopy with controlled technique, optimizes the view using positioning and adjuncts, avoids excessive force or dental trauma, and prioritizes first-attempt success. |
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| Passes the tube under continuous visualization until the cuff is beyond the vocal cords, removes the introducer, inflates the cuff with the minimum volume required for a seal, and begins ventilation. |
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| Confirms tracheal placement with a sustained waveform capnogram over multiple breaths; uses chest rise, bilateral breath sounds, tube depth, and absence of epigastric sounds only as adjuncts. |
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| Monitoring & Modifications |
| If an attempt fails, stops before critical desaturation, reoxygenates, changes operator, device, position, or adjunct as planned, limits repeated attempts, and progresses through the rescue algorithm. |
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| Post-Intervention |
| Secures the tube, records depth, measures cuff pressure, initiates ordered ventilation and sedation, reassesses oxygenation, ventilation, hemodynamics, and bilateral air entry, and obtains further confirmation when clinically indicated. |
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| Documents the indication, assessment, devices and medications, number of attempts, view, complications, tube size and depth, waveform capnography confirmation, cuff pressure, and difficult-airway notification or debrief. |
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| Post-Intervention Management Steps. |
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