Airway Assessment – The UK Approach

The UK TEAM course uses HAVNOT to cover both areas [9]:

• H: History – including previous airway problems
• A: Anatomy – anatomical features that may cause difficulty
• V: Visual clues – such as obesity and the presence of a beard
• N: Neck mobility and accessibility (including immobilisation)
• O: Opening of the mouth
• T: Trauma

However, none of these predictors is particularly sensitive and predictive tests are of limited value when the thing they are trying to predict is very rare [10].

The presence of indicators of possible difficulty does not mean an airway will be difficult; more importantly, their absence does not mean it will be easy.

It is also vital to remember that pathology compromising the airway might progress rapidly. The ‘difficulty’ of an airway is not a static concept.