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The authors propose an emergency anaesthesia framework beyond anatomy and physiology using the STEPS acronym: Self, Team, Environment, Patient (anatomical/physiological) and System, to support real-time identification of perceived and latent threats and promote more holistic airway management.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/emergency-anaesthetic-management-in-critically-ill-and-injured-patients-the-steps-approach/419948/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/emergency-anaesthetic-management-in-critically-ill-and-injured-patients-the-steps-approach/419948.png","ImageObject",300,407,{"name":92,"@type":93},"Muffet","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What does the STEPS approach stand for in emergency anaesthesia?","Question",{"text":112,"@type":113},"STEPS stands for Self, Team, Environment, Patient (anatomical/physiological) and System.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why do the authors recommend moving beyond anatomy and physiology in emergency anaesthetic airway management?",{"text":117,"@type":113},"They argue that many airway complications and risks are influenced by technical and non-technical factors, not only anatomical or physiological issues, especially in out-of-theatre environments.",{"name":119,"@type":110,"acceptedAnswer":120},"How can the STEPS mnemonic be used in real time during care?",{"text":121,"@type":113},"It provides a cognitive framework to better identify perceived and latent threats around emergency anaesthesia, supporting a more holistic management approach.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},419948,1790837775,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52,"preview_page_count":4},962090768927,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Morton et al.  \nScandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2026) 34:1  \n[https://doi.org/10.1186/s13049-025-01519-8](https://doi.org/10.1186/s13049-025-01519-8)  \nScandinavian Journal of Trauma, Resuscitation and Emergency Medicine  \nCOMMENT Open Access  \nEmergency anaesthetic management  in critically ill and injured patients: the STEPS approach (self, team, environment, patient and system)  \nSarah Morton 1,2,3*, R. Crooks4, A. Woodman-Bailey5, C. Reid6 and P. Sherren2,7  \nAbstract  \nContemporary airway management paradigms focus heavily on the anatomical and the technical considerations of‘Difficult Airway’ management. Such pervasive language does not always fully capture the critical importance of many other technical and non-technical factors that routinely impact on the safe delivery of emergency anaesthesia in the out-of-theatre environment. The authors believe that it is important to consider the factors beyond anatomy and physiology in emergency anaesthesia (EA) and recommend the following acronym and categories: Self, Team, Environment, Patient (anatomical/physiological) and System (STEPS) . The aim of this mnemonic is to provide a cognitive framework that can be utilised in real-time to better identify the perceived and latent threats surrounding EA that will hopefully encourage a more holistic management approach to airway management in critically ill and injured patients.  \nKeywords Anaesthesia, Airway management, Difficult airways, Rapid sequence induction, Critical care, Human factors  \n*Correspondence:  \nSarah Morton  \n[sarah. morton@doctors.org.uk](sarah. morton@doctors.org.uk)  \n1Imperial College London, London W2 1NY, UK  \n2Essex and Herts Air Ambulance Trust, Earls Colne, Colchester CO6 2NS, Essex, UK  \n3West Middlesex University Hospital, Chelsea and Westminster NHS Foundation Trust, Twickenham Road, Isleworth TW7 6AF, UK  \n4Imperial College NHS Trust, London W2 1NY, UK  \n5St George’s University Hospital NHS Foundation Trust, Blackshaw Road, London SW17 0QT, UK  \n6NSW Ambulance Aeromedical Operations, 33 Nancy Ellis Leebold Drive, Bankstown Airport, NSW 2200, Australia  \n7Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK  \nBackground  \nThe term“Difficult Airway” has traditionally emphasised anatomical challenges [1]. However, NAP4 highlighted that many airway complications occur from physiological and environmental factors [2]. The 2025 Difficult Airway Society (DAS) guidelines discuss the physiologically difficult airway [3]. The authors believe that it is important to consider the factors beyond anatomy and physiology in emergency anaesthesia (EA) and recommend the following acronym and categories: Self, Team, Environment, Patient (anatomical/physiological) and System (STEPS)(Fig. 1).  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/.  \nMorton et al. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2026) 34:1 ","cbCaiv8nCE5PT22z","https://ap.wps.com/l/cbCaiv8nCE5PT22z","pdf",1036996,"English","# Emergency anaesthetic management in critically ill and injured patients: the STEPS approach (self, team, environment, patient and system)\n# Abstract\n# Background\n# Main text\n## Self (STEPS)\n## Team (STEPS)","[{\"question\":\"What does the STEPS approach stand for in emergency anaesthesia?\",\"answer\":\"STEPS stands for Self, Team, Environment, Patient (anatomical/physiological) and System.\"},{\"question\":\"Why do the authors recommend moving beyond anatomy and physiology in emergency anaesthetic airway management?\",\"answer\":\"They argue that many airway complications and risks are influenced by technical and non-technical factors, not only anatomical or physiological issues, especially in out-of-theatre environments.\"},{\"question\":\"How can the STEPS mnemonic be used in real time during care?\",\"answer\":\"It provides a cognitive framework to better identify perceived and latent threats around emergency anaesthesia, supporting a more holistic management approach.\"}]","Emergency anaesthetic management in critically ill and injured patients - the STEPS approach | PDF",1790618887]