Troubleshooting the Failed Airway.

The failed airway is a high-stakes event arising from deranged physiology, challenging anatomy, and technical difficulty. Mitigation requires proactive resuscitation of the physiologically difficult airway and optimizing oral intubation techniques. Key procedural strategies include airway checklist use during all airways, prioritizing video laryngoscopy, employing progressive suction methods like suction-assisted laryngoscopy for airway decontamination, and using a bougie-first approach for introducer selection. When oral intubation fails, providers must be proficient in advanced techniques such as flexible bronchoscopy and emergency front-of-neck access. Simulation and continuous quality assurance are essential to maintain competency in troubleshooting the failed airway.