Technique to secure the airway quickly while minimising aspiration risk in non-fasted or high-risk patients.
Investigations
- • Pre-op assessment, NBM status
- • Airway assessment (Mallampati, mouth opening, neck movement)
Management
- • Pre-oxygenate 3 min with 100% O₂
- • Cricoid pressure (controversial)
- • IV induction agent + neuromuscular blocker simultaneously
- • Intubate without bag-mask ventilation
Drug therapy
- • Propofol 2 mg/kg or ketamine 1–2 mg/kg (shock)
- • Suxamethonium 1.5 mg/kg or rocuronium 1.2 mg/kg
- • Fentanyl 1–2 µg/kg for haemodynamic stability
Complications
- • Aspiration
- • Failed intubation
- • Hypotension
- • Sux: hyperkalaemia, MH
Clinical pearls
- • Plan A/B/C/D airway strategy before induction (DAS guidelines)
Educational — verify locally.
