Anaesthesia & Critical Care

Difficult Airway Prediction Score (El-Ganzouri)

Multi-variate risk score combining seven airway predictors for difficult laryngoscopy and intubation.

Score interpretation

EGRI 0–3 — Difficult Intubation Not Predicted 0–3

Below the El-Ganzouri threshold (a score of 4 or more predicts difficult laryngoscopy).

→ Standard airway management with routine backup equipment — no bedside test excludes a difficult airway.

EGRI 4–6 — Difficult Intubation Predicted 4–6

EGRI ≥ 4 predicts difficult laryngoscopy / intubation (El-Ganzouri 1996).

→ Video laryngoscopy first-line; have GlideScope/McGrath available; senior anaesthetist

EGRI ≥ 7 — High Risk 7–12

In the Besta airway algorithm an EGRI of 7 or more led to awake fibreoptic intubation (Cagnazzi 2016).

→ Awake fibreoptic intubation; surgical airway standby; DAS failed intubation algorithm

Interpretation bands for the El-Ganzouri Score. Apply clinical judgement and local guidance.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.