You could throw in a nasal trumpet if you needed to mask but she's obstructing with her tongue. Not foolproof, but could help in the situation of difficult mask, obviously just suction the NG tube and then pull it. It's not needed right now and you could just throw in an OG for the surgery. Granted equipment may not be 100% available in places outside the US like Iraq and even then there may be a lot of pressure on not using extra equipment just because one can.Basic question. So let’s say we did the inhalation induction and patient is still spontaneously breathing but the mouth is still too rigid to open, so you decide to give roc. Is there a part that we are still rolling the dice that roc will work to open her mouth? Giving roc in a closed mouth can make her obstruct with tongue/ soft tissue rolling back after muscle relaxation to make her difficult to mask? I feel like this whole situation is predicated in that we have to be 100% sure that roc will relieve her jaw rigidity. Even with mask induction getting her deep enough she can obstruct too and then lead to difficult ventilation and intubation. Personally given all that I would have done awake foi nasal as my first attempt. If in a place without fiber optic, I would do inhalational and ketamine. If that didn’t work I’d do roc and hope it opens the mouth. And with all this having colleague ready for surgical airway. My main goal is airway so would not to burn bridges by maintaining spontaneous ventilation, secondary goal would be maintaining her CPP. Keeping a close eye on BP. Thoughts?