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 Proper patient positioning is of utmost importance and should be achieved prior to any airway intervention, particularly if direct laryngoscopy is to be attempted. Proper positioning can be the difference between a successful and unsuccessful laryngoscopy attempt.

 With the provider standing at the head of the bed, the patient’s head should be as far towards the head of the bed as possible. The height of the bed should be to the provider’s preference.

 Proper positioning creates a direct line of sight from the patient’s mouth to the larynx. This is accomplished using approximately 30° of cervical flexion using pillows/blankets along with extension of the atlanto‐occipital joint, the classic ‘sniffing position.’

 Positioning obese patients may be particularly challenging. This can be accomplished by forming a ramp, elevating the upper back and shoulders in order to accommodate adequate cervical flexion. Confirming horizontal alignment of the external auditory meatus with the sternal notch can be a useful guide.