Airway Management remains the single highest risk time for our patients in pedsICU & pedsCICU. We've known about problems for long time, but finally gaining attention, new ways of thinking & new ways to use drugs & devices- there's a lot more gray then there used to be. We'll discuss resuscitation and airway management in child with cardiac disease or hemodynamic instability, introduce the concept of the resus spiral staircase and talk about how you can optimize your team, respiratory support and hemodynamics. We cover delayed sequence intubation and that not every patient needs a tube and not every patient needs a tube right now. With better drugs and devices like dexmedetomidine and non-invasive, we've actually opened up a big zone between no support and invasive ventilation. We'll discuss ECMO standby when, how, who, and then finally de-resuscitation and extubation or separation from support. This was a really big episode, so we've split it into two. The first half covered the resus spiral, team management, equipment & environment. In this second episode, we will go into respiratory and hemodynamic support, rescue strategies, including ECMO and finally extubation. Featuring regular hosts @drpetaalexander @BostonChildrens @karen_choong @MCH-childrens @drgregkelly @SCHNkids No time to listen or want to participate in the discusion? You can find a full Tweetorial of this episode on Twitter @pedsintensiva and our website here https://pedsintensiva.com