[Verse 1]
The patient's neck is frozen in a crooked angle down
Flexed and fixed, no extension — conventional grounds won't hold
You planned this from the waiting room, awake scope is the call
Topicalize the airway, spray the cords before you go all in
Glycopyrrolate to dry the field, sedation light and thin
Nasal route or oral, but the patient's still in charge
Cooperative and breathing while you navigate the large
Vocal shadow on the scope — you thread and then you pass
Confirm position with the capnograph before you gas
[Chorus]
A, B, C, D — the plan is on the wall
Attempt, Best blade, Camera, then the scalpel's final call
Spray the cords, thread the scope, keep the patient wide awake
Know the sequence cold before you ever get to take
A, B, C, D — don't skip a single rung
DAS algorithm carved into your tongue
[Verse 2]
Plan A — direct or video, optimize the head
Best external laryngeal pressure, don't declare them dead
Two attempts, no more, then pivot — stubborn pride costs air
Plan B brings the supraglottic, SAD goes in right there
iGEL or classic LMA, oxygenate the gap
Can you pass the tube through it? Try — but read the map
Plan C, if ventilation fails, you call the room to hush
One last mask attempt before the final push
[Chorus]
A, B, C, D — the plan is on the wall
Attempt, Best blade, Camera, then the scalpel's final call
Spray the cords, thread the scope, keep the patient wide awake
Know the sequence cold before you ever get to take
A, B, C, D — don't skip a single rung
DAS algorithm carved into your tongue
[Bridge]
And then the child comes out of the sevoflurane mist
Laryngospasm clamps the cords — a reflex you can't dismiss
Jaw thrust forward, CPAP pressure, call it Larson's point
Notch behind the ear, the mastoid, press it to the joint
Ten seconds of firm pressure — cords may break their grip
If hypoxia deepens — sux, one milligram per kilo, quick
Never freeze in silence when the small airway defies
The physics of a pediatric glottis the size of your eyes
[Verse 3]
Self-assessment lives between the action and the debrief chair
Did you recognize the moment when Plan A was no longer fair?
Did you call for help before the saturation scrolled toward grey
Or tunnel down alone because your ego owned the day?
The simulation room forgives — the actual OR does not
So index every hesitation, every thing you almost forgot
Rate your own decision tree, not just the outcome's grade
The airway saved by luck and the airway saved by trade —
Only one of those will replicate when pressure hits the blade
[Chorus]
A, B, C, D — the plan is on the wall
Attempt, Best blade, Camera, then the scalpel's final call
Spray the cords, thread the scope, keep the patient wide awake
Know the sequence cold before you ever get to take
A, B, C, D — don't skip a single rung
DAS algorithm carved into your tongue