Simultaneous induction + paralysis with cricoid pressure (traditional) to intubate a patient at risk of aspiration.
Indications
- • Non-fasted patient needing emergent intubation
- • GI obstruction
- • Pregnant patient
Contraindications
- ⚠ Anticipated difficult airway without awake option
Equipment
- • As per intubation kit
- • Induction: ketamine/etomidate/propofol
- • Paralytic: succinylcholine 1.5 mg/kg or rocuronium 1.2 mg/kg
Positioning
- • As appropriate for the procedure and patient comfort.
Consent
- • Explain indication, benefits, alternatives
- • Explain risks & complications
- • Obtain written/verbal consent as per SOP
- • Document consent
Universal precautions
- • Hand hygiene
- • PPE — gloves, mask, eye protection
- • Aseptic technique
- • Sharps safety
- • Verify patient identity & site
Step-by-step (0/7)
Tap to complete
SOAP-ME — Suction, O2, Airway equipment, Positioning, Monitoring, ETCO2.
Immediate complications
- ⚠ Hypoxia
- ⚠ Hypotension
- ⚠ Aspiration
- ⚠ Failed intubation
Delayed complications
- • Awareness
Recognition
- • Vital sign changes
Initial management
- • Follow difficult airway algorithm
- • Push-dose pressors for hypotension
Prevention
- • Full preparation
- • Adequate pre-oxygenation
Post-procedure observation
- • Vitals q15min × 1h then hourly
Monitoring
- • Site inspection
- • Symptom review
Documentation
- • Procedure note
- • Consent
- • Findings
Patient instructions
- • Report pain, bleeding, fever, worsening symptoms
Drugs used in this procedure
Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.
