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A focused examination of the airway is used to identify patients who are predicted to experience difficulties with traditional airway management procedures. These procedures commonly include BMV, placement of an extraglottic airway device (e.g., LMA™), or direct laryngoscopy and intubation.

Several clinical predictors of a difficult airway are described below. There is no single test that is both highly sensitive and specific in predicting difficulties. Based on the patient’s medical history and using a combination of clinical examinations, we are able to improve our ability to identify patients who will require special attention and equipment so as to provide them with safe airway management.

Difficult BMV is defined as the inability to provide adequate bag-mask ventilation and maintain oxygen saturation > 90%. The mnemonic “BONES” summarizes the common predictors of difficulty with BMV.