In cardiac arrest, after the first endotracheal intubation attempt, which options may be used?

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In cardiac arrest, securing a reliable airway while keeping chest compressions uninterrupted is key. If the first attempt at endotracheal intubation doesn’t succeed or ventilation remains inadequate, you have several valid paths to maintain oxygenation and ventilation. You can retry the intubation if conditions and skill permit. If intubation remains difficult or unsuccessful, you can rapidly place a King LT-D to establish a patent airway and continue effective ventilation during ongoing CPR. If advanced airway options aren’t immediately available or if ventilation is still challenging, you can temporarily revert to bag-valve-mask ventilation to ensure oxygen delivery while you reassess or prepare the next step. Because each of these approaches may be appropriate depending on how the patient responds and the situation on scene, all of these options may be used. Remember to confirm airway placement with capnography and monitor ventilation continuously throughout.