Difficult Airway

The other day, while I was running elective list, my colleague running the emergency OT called me. Went out to the reception area to see what's going on... Lo and behold, this is what we have (I have the patient's permission to use his photo as education material).

ThyroMental Distance is only 1 finger breadth. We proceed with caution.We explained to him his risk and also our options if we can't intubate him. Then he was induced with propofol and test ventilated to make sure we can ventilate him with face mask. Then my colleage did a lanryngoscopy and found that it was Cormack Lehane Grade IV. I took the McCoy blade and do another laryngoscopy and this time it is Cormack Lehane III with a good cricoid pressure. After confirmation of the laryngoscopy finding then only we gave suxamethonium followed by intubation without any problem. Post operatively, we informed him again about our finding and tell him to inform his next doctor if he had to go under another GA in the future. Who knows he might came in late at night and some heroes might book him for a GA case without notice the airway. It might just cause unnecessary stress to the anaesthtist at the wee hour.