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Teaching step

Step 2: Timeout

Convert implicit assumptions into a shared, spoken airway plan.

Core teaching points

  • Indication
  • Physiology risk
  • Allergies
  • Induction/paralytic doses
  • Induction agent before paralytic — announce order
  • Pressor/resuscitation plan if BP falls
  • Plan A/B/C
  • What changes after failed attempt
  • CICO trigger
  • Post-intubation analgesia/sedation ready

Pearls

The timeout should be short enough to actually happen and explicit enough that the team knows when to pivot.

Room script: This is an airway for __. Main risk is __. Induction agent is __ and goes before paralytic __. If BP falls, pressor/resuscitation plan is __. Plan A is __. If we fail, we oxygenate and change __. Plan C is __. Analgesia/sedation after the tube are ready.

Pitfalls

  • Calling “Plan B” without specifying what changes
  • No post-intubation sedation ordered before paralysis
  • Paralytic pushed before the induction agent is announced/given
  • No explicit pressor/resuscitation plan if BP falls
  • Shock/acidosis/RV risk not discussed
  • No named CICO trigger