The PREPARE Phase: Resuscitation Before Intubation

The Airway Playbook for Physiologic Control.



Endotracheal intubation in the emergency department is often perceived as a procedural milestone—but in critically ill patients, it represents one of the most dangerous transitions in care. Peri-intubation hypoxia, hypotension, and cardiac arrest are not uncommon, and are frequently the consequence of inadequate physiologic preparation rather than technical failure.



This session introduces a paradigm shift: The airway is a procedure—but resuscitation is the treatment.



Using a systems-based, evidence-informed approach, this talk presents the PREPARE framework—a structured method to optimise oxygenation, haemodynamics, and metabolic physiology before intubation.



Framed as an Airway Playbook, the session integrates key concepts including:

Preoxygenation strategies (NIV, HFNO, positioning)

Haemodynamic optimisation and peri-intubation shock prevention

Identification and management of high-risk physiology (HOP killers)

Delayed sequence intubation (DSI) and resuscitation sequence intubation principles

Cognitive offloading through structured planning and team preparation

The critical transition from unstable patient → controlled intubation



A high-yield, clinically grounded talk for emergency and critical care clinicians looking to move from crash airways to controlled physiology-driven intubation.