Difficult airway assessment focused on: - Facial anatomy that might affect mask seal in case bag-mask ventilation is needed (heavy beard, disruption of lower facial continuity, excessive blood and secretions)
- Oral cavity (Mallampati score I through IV, evaluate for 3-3-2 rule*, potential for obstructive laryngeal abnormality or dysfunction, presence of functional tracheostomy, presence of endotracheal tube)
- Jaw anatomy (limitation of mouth opening due to maxillofacial trauma, congenital disorder, oral disease, loose teeth/dentures)
- Neck mobility (unstable cervical spine; metastatic bone disease; diminished range of motion secondary to cervical spine surgery or disorders, such as ankylosing spondylitis or polyarthritis)
- Body weight and habitus (obesity-related large or short neck, obesity-related hypoventilation, congenital disorders, inability to lie supine, pregnancy)
- Medical disorders that can affect respiration and oxygenation
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Staff and technical assistance: - Role allocation (team leader, what to do in case of airway compromise or procedure-related complications)
- Verbalize the procedural plan
- Anesthesia team (plan ahead/drugs)
- Bronchoscopy assistance team (plan ahead)
- Operating room/procedure suite nursing team
- Monitoring vital signs (oximeter, blood pressure, respiratory rate, electrocardiography, and end-tidal carbon dioxide if warranted)
- Informed consent
- Time-out
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