Clinical-use limit: Educational resource and cognitive-aid guide only; not a bedside order set or substitute for local protocol, medical direction, or clinical judgment.
Before intubation
- Call anesthesia/ENT/airway backup early; assess tongue, floor of mouth, voice, stridor, and progression.
- Prepare awake or spontaneous-ventilation strategy when indicated.
- Stage surgical airway equipment and declare the trigger for front-of-neck access.
During intubation
- Avoid repeated traumatic attempts that worsen edema.
- Keep oxygenation and spontaneous ventilation when feasible.
- If deterioration occurs, move decisively to the declared rescue pathway.
After intubation
- Secure tube, avoid accidental extubation, and communicate difficult-airway status.
- Continue disease-specific therapy and ICU monitoring.
- Document airway findings and rescue pathway.
Common pitfalls
- Waiting until complete obstruction.
- Paralyzing before rescue plan is realistic.
- Multiple blind attempts in a swollen airway.