Verse 1 – Definition in the Chaos Failed airway means we reach the line, Can’t ventilate or oxygenate ≥ ninety percent in time. After attempts that still don’t succeed, Or anatomy won’t let us proceed. Three attempts max by the most skilled hand, AEMT or Paramedic making the stand. Each attempt must change the plan or gear, No repetition allowed in here. NO MORE THAN THREE TOTAL—we stop, we shift, Patient oxygenation is the gift. Chorus If we can’t ventilate, we don’t persist, We change the path, we adapt like this. Oxygen first, EtCO₂ in sight, Capnography guiding every fight. If saturation stays ninety-two or more, We hold the line, we secure the core. Verse 2 – Monitoring the Fight Capnography always on the screen, End-tidal CO₂ keeps the scene clean. Mandatory monitoring, every breath we trace, Every waveform tells us pace. BVM first with adjunct airway aid, OPA, NPA carefully made. Supplemental oxygen keeps levels high, We reassess before we try. If saturation holds, we continue this way, Basic airway support may stay. If not, we escalate, controlled and tight, Between each attempt we preoxygenate right. Pre-Chorus – Decision Point Call for resources if they’re near, Backup airway teams may appear. Blind insertion airway device may be next, If BVM support is complex. But always oxygenate between each try, Never rush as saturation drops by. Chorus Failed airway—no more than three, Every attempt must change strategy. Ventilate first, oxygen restore, We don’t keep repeating what failed before. EtCO₂ guides us through the night, Waveform steady means we’re right. Verse 3 – When We Reach the Edge If anatomy won’t let us succeed, Or oxygenation cannot be freed, We stop advanced attempts and shift the plan, Protect the patient as best we can. Cricothyrotomy—final resort, Only when all other paths fall short. Surgical airway, last in line, Twelve years and older only defined. We maintain BVM with adjunct support, Keep oxygen flowing, stabilize transport. Post-intubation or BIAD care, If tube is placed—we manage there. Secure every airway, don’t let it shift, During movement, transfers—manual lift. DOPE reminder always in view: Displacement, obstruction, pneumothorax too. Equipment failure can change the game, We reassess, we don’t stay the same. Bridge – Position and Precision Position is everything in the fight, Ear canal to notch in straight line sight. Sniffing position, airway aligned, Obese or pregnant—elevate behind. Stretcher raised to the proper height, Umbilicus level helps us get it right. Trauma patients keep in-line care, Manual stabilization always there. Verse 4 – The Rule of Discipline If BVM keeps saturation steady and strong, We may continue basic path along. Ten to twelve breaths per minute we give, EtCO₂ guiding how they live. If first attempt fails, we don’t repeat, We adjust approach, make technique complete. Different provider, different device, We don’t roll dice twice. Gastric tube if time allows, To reduce complications somehow. Secure the tube with every move, Every transfer we must improve. Final Chorus No more than three—we know the rule, Airway management is precise, not cruel. Oxygen first, then escalate slow, We follow the path the numbers show. Capnography steady, saturation bright, We fight the fight with data and sight. When airway fails, we don’t despair— We pivot, adapt, and secure the air. Outro From first attempt to final call, We protect the patient through it all. No panic, no repetition, no guess— Just protocol under stress. And if all else finally breaks away, We build a new airway to save the day.
