Abstract
Awake tracheal intubation is a valid and highly recommended option for any situation where significant anticipated difficult intubation is expected. Despite expert recommendations and available video assisted device it’s not a common practice and it still underuse because it seems as a very complex procedure. With a well-structured protocol, education and training, most health care personnel in the emergency department could perform it in a matter of minute, without delaying urgent care and maintaining a patent airway for adequate oxygenation.