In the absence of anesthetic or surgical contraindications return to spontaneous breathing and extubation shall be attempted immediately after surgery, especially in patients undergoing thoracic surgery.

Preoperative evaluation of the airway for predictors of difficult airway shall also be performed in the outpatient setting.

Patients with a predicted difficult airway, especially those with anatomic (postoperative) airway changes, syndromes, or tumors, shall not be managed as outpatients without access to an inpatient facility.

Postoperatively, a recovery room shall be available that allows for oxygenation and monitoring equipment, as well as the use of (the patient’s own) CPAP device.

Materials for all levels of airway management shall be available for ambulatory anesthesia outside of dedicated operating rooms.

A video laryngoscope shall be available as an alternative to the direct laryngoscope.

All patients undergoing general anesthesia and moderate or deep sedation, regardless of the length of the procedure and the site of anesthesia, shall be monitored by continuous capnography.

The benefits and risks shall be carefully weighed when determining the indication for intubation in critically ill patients in the ICU. Indication for intubation may be more liberal to avoid hypoxia.

All patients should be assessed in a structured manner on admission to the ICU for the likelihood and presence of predictors of difficult airway management, and the outcome should be visibly documented.

Airway management in the ICU shall be performed or supervised by physicians and nursing staff experienced in airway management.