We discuss intubation in the critically ill patient with special focus on as aspect that is usually lacking or ignored – the ‘physiological airway’. We all know about the anatomic preparation with LEMON mnemonics of the airway assessment but what about the physiologic difficulties when tubing the sick patient? This is where Emergency Medicine has the niche and knowing how to optimise the airway is essential Fellowship Knowledge. Please see the basic outline scenario for this SAQ – the answer scheme is deliberately not detailed, the podcast has more detailed discussion around this. SAQ