Difficult Airway Management Outside the Operating Room

Abstract

Difficult airway management outside the operating room (OR) remains one of the most complex challenges in anaesthesia. The increasing frequency of interventional procedures performed in non-OR settings, such as the intensive care unit, emergency department, and prehospital environments, presents unique challenges related to logistics, personnel, and equipment availability. Unlike the controlled OR environment, these settings are associated with a higher incidence of airway-related complications and mortality. This narrative review aims to explore the incidence, complications, and strategies to optimize difficult airway management outside the OR, improving patient safety and clinical outcomes, while discussing key factors such as anatomical, physiological, and situational challenges that contribute to the increased difficulty of airway management in non-OR environments. Despite advancements in airway technology and the dissemination of clinical guidelines, airway-related complications in non-OR settings continue to pose significant risks. The review's findings underscore the need for standardized protocols, comprehensive training, and a systematic approach to difficult airway management. By integrating human factor training, multidisciplinary collaboration, and optimized equipment availability, patient safety can be significantly enhanced.