When difficulty with mask ventilation, laryngoscopy or mask ventilation is likely, careful consideration should be given to securing the airway awake.

The most important predictor of difficulty with awake fibre-optic intubation (AFOI) is lack of patient co-operation and operator experience.

The use of AFOI for cases of airway obstruction remains controversial.

Blood and copious secretions in the airway may hamper or prevent vision via a fibrescope.