In this episode, Steve, Dan, and Holly talk with Bruce Opsal, a long-time firefighter and paramedic who has spent years leading training programs centered on effective airway management and ventilation. Bruce first emphasizes the importance of airway management in any patient, especially those in cardiac arrest. The team talks about how the previous line of thought was to assign the airway to the least experienced provider and then forget about it. However, this is evolving in pre-hospital management as we better understand the importance of careful and attentive airway management. Bruce then introduces his 6-step process for confirming effective ventilations, and through this discussion, providers of all levels can glean helpful tools for effective airway management and successful delivery of ventilations. The team spends the most time on one step that is not often well understood, which is end-tidal (ETCO2). Throughout their discussion, Bruce and the team go through what end-tidal is measuring, how it can confirm effective PPVs and/or airway placement, and how it can be used to manage a patient successfully during cardiac arrest. This episode allows listeners to challenge the current thought processes around out-of-hospital airway management and gives a new perspective on effectively managing an airway.