Initially, every attempt must be made to achieve ventilation and oxygenation via non-invasive techniques as described previously, including:

• Two or three person bag mask ventilation
• Maximal head extension and jaw thrust
• Oral and/or nasal airway
• Reduction or release of cricoid pressure
• A maximum of two further attempts at insertion of either the classic or ProSeal LMA

If at any point successful oxygenation is achieved, the patient should be awakened, if at all possible.

If further desaturation occurs and the patient cannot be ventilated (especially in the presence of developing bradycardia), then an invasive rescue technique should be used.