When manipulating the airway, correct patient posi-tioning is required. Relative alignment of the oral and pharyngeal axes is achieved by having the patient in the “sniffing” position. When cervical spine pathol-ogy is suspected, the head must be kept in a neutral position during all airway manipulations. In-line stabilization of the neck must be maintained dur-ing airway management in these patients, unless appropriate films have been reviewed and cleared by a radiologist or neurological or spine surgeon. Patients with morbid obesity should be positioned on a 30° upward ramp, as the functional residual capacity (FRC) of obese patients deteriorates in the supine position, leading to more rapid deoxygen-ation should ventilation be impaired.
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