What constitutes an invasive airway attempt?

• A. Insertion of the tip of the laryngoscope blade or SGA past the incisors.
• B. Insertion of a tracheostomy tube.
• C. Placement of an endotracheal tube after first prep.
• D. Insertion of an oropharyngeal airway.

Answer: (A)

The main idea here is distinguishing when airway management becomes invasive. An invasive airway attempt is when a tool actually enters the airway space with the goal of securing it, which starts the moment you pass a device through the lips past the incisors into the oropharynx to visualize or access the airway.

Inserting the tip of a laryngoscope blade or a supraglottic airway beyond the incisors is exactly that moment: you’re penetrating into the airway area with instrumentation to facilitate ventilation or intubation. This makes it the defining invasive step.

In contrast, placing an oropharyngeal airway is considered a noninvasive adjunct, since it sits in the mouth/oropharynx without actively entering deeper airway structures. Procedures like a tracheostomy tube or an endotracheal tube are invasive as well, but they represent later, more definitive steps rather than the initial invasion identified by crossing the incisors with the instrument.