A Difficult-Airway Prediction Tool for Emergency Airway Management: The HEAVEN Criteria

This study validated the HEAVEN criteria as a tool for predicting difficult airways during emergency rapid sequence intubation (RSI) in a large air medical cohort of 2,419 patients. Each HEAVEN criterion was independently associated with lower first-attempt success, and overall intubation success decreased as more criteria were present (from 94% with none to 43% with five or more). The criteria demonstrated high negative predictive value, supporting their usefulness for identifying difficult airways in emergency RSI settings.