see also: [[Peri-intubation collapse]], [[Airway|Intubation]] **indications** patients who do not require immediate airway mgmt, are cooperative, and: 1. suspected to have a difficult anatomy (eg radiation, prior surgery) 2. likely to need airway management soon (eg angioedema) 3. high risk of decompensation during RSI **procedure** | consideration | management | | ----------------------- | ------------------------------------------------------------------------ | | prepare | - IV access<br>- Cardiac monitor<br>- cricothyrotomy kit<br>- RSI mets | | position | - upright<br>- glycopyrolate 0.2mg IV 15 min prior<br>ondansetron 4mg IV | | topical meds | 5mL of 5% lignocaine to posterior tongue<br>10 mL of lignocaine atomised | | sedation and anxiolysis | - small doses only<br>- ketamine 10-20mg Q2min | | intubation | - pre-oxygenation<br>- load ETT onto bronchoscope | | post-intubation care | - confirm placement and secure<br>- analgesia and sedation |