Predicting an anatomically and/or physiologically challenging airway is not a straightforward task by any stretch of the imagination.  There are some existing difficult-airway prediction tools available (i.e. LEMON = Look externally, Evaluate 3-3-2 rule, Mallampati score, Obstruction, Neck mobility), but many of them were derived in an elective surgery setting and may not be as applicable to emergency airway management.  Additionally, these prediction models only focus on anatomical challenges and ignore physiologic ones. Several components of the LEMON approach require an awake, cooperative patient. The authors of this paper derived a tool, called the HEAVEN criteria (Hypoxemia, Extremes of size, Anatomic abnormalities, Vomit/blood/fluid, Exsanguination, Neck mobility issues) to address this clinical need. #Diagnosis #EM #PCC #Heaven #Criteria #Difficult #Airway #RebelEM