In this podcast episode, Dr. Dan Patino delves into the intricacies of awake intubation, a critical procedure in emergency medicine. He highlights the potential risks associated with paralyzing patients, emphasizing how it can worsen acidosis and increase the chances of Peri-Intubation Arrest. Dr. Patino contrasts the standard approach of Rapid Sequence Intubation (RSI) with the scenarios where awake intubation proves essential, shedding light on the characteristics of ideal candidates and the categories of difficult airways. The episode covers crucial steps in preparing for the procedure, including room setup, drying the mouth, and effective topicalization techniques. Dr. Patino provides valuable insights into the use of medications, such as ketamine, and outlines the procedural nuances for both oral and nasal intubation. Listeners gain a comprehensive understanding of awake intubation, its indications, and the meticulous approach required for optimal patient outcomes.