Intubate

  1. preoxygenate 100% O2 via bag/mask
  2. intubation meds
  3. cricoid pressure (Sellick maneuver), do after atropine and before sedative/paralytic
  4. open mouth w/ right hand
  5. insert blade to R mouth as far as possible handle pointing 3 oclock, sweep tongue to L by turning counterclockwise to 12 oclock, if using straight blade put it below epiglottis and elevate it, if using a curved blade, place it in vallecula and pull epiglottis upward
  6. pass ETT from R corner of mouth, until cuff is just beyond the cords, in an uncuffed tube, look for a mark - putting the tip in midtrachea. Hold tube against upper teeth, and withdraw blade.
  7. verify ETT position: listen to both axillae and stomach, look at chest rise/fall, condensation in ETT, ETCO2, CXR,
  8. tape ETT

If intubation can't be done in 20 seconds, ventilate BVM while maintainig cricoid pressure.