Emergency airway checklists are increasingly used in emergency medicine, critical care, anesthesiology, and prehospital systems to improve preparation, reduce omissions, and support team communication during airway management. Despite widespread adoption, there remains no broadly accepted framework defining optimal airway checklist structure, operational design, or bedside usability. The purpose of this review was to identify the core operational and human-factor characteristics associated with effective airway checklists and propose a generalized framework for future airway checklist development.

A focused comparative review was conducted using a representative emergency department (ED) airway cart checklist alongside major published airway checklist models and guideline-supported frameworks, including those from the Difficult Airway Society (DAS), Society of Critical Care Medicine (SCCM), New South Wales/Agency for Clinical Innovation (NSW/ACI), and EmergencyCareBC. Across reviewed airway checklists, the most consistently high-yield elements included role allocation, oxygenation strategy, suction readiness, physiologic optimization, backup airway planning, escalation pathways, and post-intubation confirmation with waveform capnography. Operationally effective checklists emphasized brevity, visual clarity, and compatibility with verbal bedside workflow, whereas excessive medication dosing information, troubleshooting algorithms, and reference-style content frequently reduced usability during time-sensitive airway management.

Airway checklist effectiveness appears to depend as much on usability and implementation as on content completeness. High-functioning checklists prioritize omission-prone tasks, communication structure, physiologic preparation, and deliberate escalation while minimizing unnecessary cognitive burden. This review proposes a generalized airway checklist design framework emphasizing concise read-aloud workflow, explicit backup planning, and post-intubation stabilization.