Airway Management and Ventilation
What you must understand
Know the sequence of airway assessment, positioning, preoxygenation, and confirmation of placement. Understand bag-mask ventilation, supraglottic devices, endotracheal intubation, and surgical airway as a graded approach. Master the predictors of difficult mask ventilation and difficult intubation, and know the difficult airway algorithm conceptually: optimize, call for help, use alternative devices, and proceed to invasive airway if needed. Understand confirmation of tube placement by sustained waveform capnography, not auscultation alone. Know the risks of aspiration, laryngospasm, and bronchospasm during induction and emergence. Understand oxygen delivery devices and the difference between oxygenation and ventilation. Recognize the signs of esophageal intubation and the immediate response.
Traps in questions
Questions often present a patient desaturating after intubation; the correct first step is to verify tube position with capnography and assess for displacement, obstruction, pneumothorax, or equipment failure. Another trap is choosing a supraglottic device in a patient with high aspiration risk or a full stomach. Do not accept chest rise or breath sounds as definitive proof of tracheal placement.
Rule of thumb
If the airway is lost, follow a simple order: call for help, oxygenate, confirm the problem, then intervene. Never remove a working airway without a plan to replace it.