Clinical assessment for the identification of the potentially difficult airway

A core component of perioperative safety is airway management because patients are at risk for apnea, upper airway obstruction, and hypoxemia while under anesthesia. Every patient should be assessed preoperatively for potentially difficult airways in order to facilitate planning and preparation. Airway assessment includes a focused history and airway examination; imaging and endoscopy may be necessary in patient suspected to have challenging airways. Airway management can be divided into four aspects: bag mask ventilation, tracheal intubation, insertion of supraglottic airway and surgical airway. This narrative review summarizes bedside airway examinations and predictors of difficult airway in each of these aspects. However, in spite of these predictors, situations of an unanticipated difficult airway can still occur.