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    Subjects/Anesthesia/Awake Fiberoptic Intubation
    Awake Fiberoptic Intubation
    hard
    syringe Anesthesia

    A 48-year-old woman with a history of severe rheumatoid arthritis affecting the cervical spine is scheduled for elective thyroid surgery. Preoperative assessment confirms limited neck extension and a Cormack-Lehane Grade III view on indirect laryngoscopy. The patient is anxious but cooperative. After topical anesthesia has been applied and the fiberoptic scope is advanced to the level of the vocal cords, the scope becomes obscured by secretions and blood-tinged fluid. What is the most appropriate immediate action?

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