According to the 2000 AHA ACLS Guidelines, tracheal intubation should only be attempted “by healthcare providers experienced in performing this skill”, and expand further by stating that “ALS providers unable to obtain regular field experience… should use alternative, noninvasive techniques for airway management”. This year ILCOR examined evidence to determine if one airway is superior to another in terms of survival and neurologic outcome in cardiac arrest. According to the evidence summary “there is inadequate evidence to show a difference in survival or favorable neurologic outcome”, and recommend that the “choice of bag-mask device versus advanced airway insertion, then, will be determined by the skill and experience of the provider”. The clinician must have sufficient initial and continuing education for whatever airway they choose, and must effectively do so while limiting interruptions in quality CPR. Some EMS services have demonstrated a 99% success rate for endotracheal