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    Subjects/Anesthesia/Difficult Airway Algorithm
    Difficult Airway Algorithm
    hard
    syringe Anesthesia

    A 38-year-old woman with a history of oral submucous fibrosis (OSMF) and trismus (mouth opening 1.5 cm) is scheduled for elective thyroid surgery. Awake fiberoptic intubation is planned. After topicalization with 4% lidocaine spray and 10% lidocaine gel, you attempt nasal fiberoptic intubation but encounter severe epistaxis from the right nostril, obscuring the view. The patient is maintaining spontaneous ventilation and oxygen saturation is 96% on room air. What is the most appropriate next step?

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