Patient factors |
Age; younger higher risk than older |
Premature birth |
Upper respiratory tract infection (≤2 weeks) |
Recurrent wheezing |
Current/past asthma |
Nocturnal dry cough |
Wheezing during exercise |
Hayfever |
Current/past eczema |
Family history of asthma, eczema, hayfever |
Passive/active smoker |
Other respiratory illnesses (eg, bronchopulmonary dysplasia, cystic fibrosis) |
Previous history of apnea |
Obstructive sleep apnea |
Obesity |
Syndromes associated with airway obstruction (eg, Down Syndrome) |
Anemia, hematocrit level less than 30% |
Unfasted patient |
Surgical factors |
Shared airway procedures (eg, ear, nose, and throat; dental; respiratory) |
Blood, secretions in upper airway |
Sudden surgical stimulation |
Emergency procedure |
Anesthesia-related factors |
Premedication with midazolam |
Topical airway lidocaine |
Inhalational induction of anesthesia |
Invasive airway management (endotracheal tube > laryngeal mask airway > facemask) |
Less experience with airway management |
Insufficient supervision ratio for trainees (eg, supervisor absent for critical periods during anesthesia) |
Desflurane administration |
High-dose opioid administration, intraoperative or postoperative |
Administration of neuromuscular blocking agents |
Nurse-to-patient ratio in the recovery area (<1:1) |
Mixed anesthetic clinical practice (adult/pediatric > solely pediatric) |
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