Endotracheal intubation in the operating room (OR) and the ICU are different procedures, but this is not always recognized. The ICU patient should be evaluated as a physiologically difficult airway, in contrast to the traditional difficult airway evaluated in the OR. ICU intubation usually occurs in an unstable patient often with a short period of time to allow for evaluation and planning, and in an environment not always ideally suited to airway management.

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