{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:44:55Z","timestamp":1791888295054,"version":"4.3.4"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Awake tracheal intubation is recommended for the anticipated difficult airway, but its application worldwide is poorly understood. We performed an international survey to understand more about the current global utilisation of awake tracheal intubation and barriers to its more widespread implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The online survey consisted of 34 multiple\u2010choice questions and three open questions available for 13\u2009months. Each participant agreed to anonymised data collection and analysis before undertaking the survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data were collected from 102 countries with 4728 responses. In total, 3190\/4184 (76.2%) respondents stated that they were performing awake tracheal intubation independently and 2512\/3035 (82.8%) used awake tracheal intubation for a combination of predicted anatomical difficulty and physiological risk. A decrease in awake tracheal intubation use was perceived by 1733\/4204 (41.2%) following the widespread implementation of videolaryngoscopy. There were 2867\/3695 (77.6%) respondents who felt that indications for awake tracheal intubation should be reassessed, although only 1844\/3831 (48.1%) reported being familiar with awake tracheal intubation guidelines. Most used a combination of topical airway anaesthesia and systemic medications to facilitate awake tracheal intubation. There were 2521\/3039 (83.0%) respondents who preferred to use a flexible endoscope, although a lack of skill in using flexible bronchoscopy was reported by 586\/966 (60.7%) as limiting their confidence in awake tracheal intubation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Despite guidelines recommending use of awake tracheal intubation for the predicted difficult airway, its application is heterogeneous. Our data suggest that a lack of physician exposure to awake tracheal intubation, possibly associated with expanding use of videolaryngoscopy, may adversely impact clinician confidence in performing the procedure. Most respondents consider awake tracheal intubation to be a core skill for anaesthetists and, furthermore, videolaryngoscopy can be used to perform some awake tracheal intubations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.70291","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T03:33:35Z","timestamp":1784172815000},"page":"1481-1488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Awake tracheal intubation in the era of videolaryngoscopy: an international survey of 4728 clinicians"],"prefix":"10.1111","volume":"81","author":[{"given":"Gerardo","family":"Cortese","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Intensive Care and Emergency Citt\u00e0 della Salute e della Scienza Turin  Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9610-399X","authenticated-orcid":false,"given":"Irene","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Intensive Care and Emergency Citt\u00e0 della Salute e della Scienza Turin  Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Brazzi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Intensive Care and Emergency Citt\u00e0 della Salute e della Scienza Turin  Italy"},{"name":"Department of Surgical Science University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Sorbello","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Hospital \u201cGiovanni Paolo II\u201d, ASP Ragusa  Ragusa Italy"},{"name":"Department of Anaesthesia and Intensive Care, School of Medicine University of Enna \u201cKore\u201d  Enna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imran","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Guy's and St Thomas' NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila N","family":"Myatra","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Critical Care and Pain Tata Memorial Hospital, Homi Bhabha National Institute  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Kovacs","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Anesthesia, Medical Neurosciences, Continuing Professional Development and Medical Education, Faculty of Medicine Dalhousie University  Halifax NS Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Adam Law","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Pain Management and Peri\u2010operative Medicine, Faculty of Medicine Dalhousie University  Halifax NS Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Greif","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199303000-00028"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14904"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004002"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630\u2010013\u20100020\u2010x"},{"key":"e_1_2_6_6_1","first-page":"201","article-title":"Algorithms for difficult airway management: a review","volume":"75","author":"Frova G","year":"2009","journal-title":"Minerva 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