Orotracheal intubation is an advanced method of securing airways, which requires regular training, regular practice and knowledge of procedures in situations of "I can't intubate, I can ventilate" and "I can't intubate, I can't ventilate". At the same time, intubation often requires the administration of intravenous anesthetics in combination with muscle relaxants, the use of which also requires practice and experience (especially addressing the side effects of the drugs used). In prehospital emergency medicine, the incidence of difficult intubation and complications during intubation is much higher compared to hospital conditions. Therefore, when deciding to intubate, it is necessary to have prepared and trained various plans in case the intubation fails.
Before intubation, it is recommended to preoxygenate patient, if the situation allows, then decide whether sedation and muscle relaxation are needed. If the patient is areflexive (no cough, swallowing or vomiting reflex is present), intubation can be performed without sedation. However, it is also necessary to think about the possible irritation of the sympathetic or parasympathetic nerve, which can lead to changes in heart rate, blood pressure or intracranial pressure.