2025 Pulmonary and Critical Care Medicine Fellows Course (INVITE ONLY)-Chest Airway Checklist

Chest Airway Checklist - learner handout

Pdf Summary

This Airway Management Checklist is a structured guide designed to ensure safe and effective intubation in critical care settings. It includes key roles such as Team Leader, Intubator, BVM Team, and Watcher, with designated times, location, and necessary medications.<br /><br />Equipment and positioning checklist covers the essentials: bag-valve-mask (BVM) with oxygen, PEEP valve, oral/nasal airways sized appropriately, laryngoscope and blades, ET CO2 detector, suction, stylet, and backup devices like intubating esophageal gastric airways (EGA), bougie, video laryngoscope, and cricothyrotomy kit. Patient positioning emphasizes head extension, "sniffing" position with ear aligned to the sternal notch, and appropriate bed height for the intubator.<br /><br />Medication guidelines specify induction agents such as etomidate (0.3 mg/kg, reduced dose if hypotensive or elderly), ketamine (1-2 mg/kg), propofol (1.5 mg/kg), and paralytic agents like succinylcholine (1-1.5 mg/kg, with contraindications including burns, neuromuscular disease, and hyperkalemia) and rocuronium (1-1.5 mg/kg). Pressors like phenylephrine and norepinephrine should be immediately available for all intubations.<br /><br />The plan section enforces a stepwise approach: Plan A involves initial intubation attempts under sedation (awake/asleep, RSI), Plan B calls for additional help and alternative devices if initial attempts fail, and Plan C involves cricothyrotomy with continued ventilation via iEGA if needed.<br /><br />The “APPROACH” steps detail a time-based process from airway assessment and team role assignment (−5 min) through preoxygenation, preparation, plan review, oxygen cutoff criteria, medication administration, intubation, and post-intubation care including tube securing and sedation.<br /><br />This checklist serves as a critical tool to standardize airway management while prioritizing patient safety, communication, and readiness for complications. It is a supplement to clinical judgment, not a replacement.

Keywords

Airway Management

Intubation Checklist

Critical Care

Bag-Valve-Mask

Laryngoscope

Induction Agents

Paralytic Agents

Cricothyrotomy

Preoxygenation

Post-Intubation Care