3-3-2 Rule


4.5 out of 5 (69 Reviews)



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Expiration Date

31 Dec 2023

Last Reviewed

1 Jan 2021

Estimated Time To Finish

60 Minutes

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Activity Description

The airway is one of the most critical elements of patient safety, and difficult intubations commonly cause morbidity and mortality. To decrease morbidity and mortality associated with intubation, interprofessional team members must properly evaluate risks and recognize which patients are most likely to be difficult to intubate. This will allow the interprofessional team to prepare accordingly, thereby reducing the risk of complications and improving patient outcomes. This activity reviews the 3-3-2 rule, an assessment tool used to predict difficult intubations based on characteristics of difficult airways, and highlights the role of the interprofessional team in evaluating patients who may need intubation.

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Target Audience

This activity has been designed to meet the educational needs of physicians.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Summarize the 3-2-2 rule.
  • Identify components of the Mallampati scoring.
  • Review the importance of evaluating for airway obstruction.
  • Explain the 3-3-2 rule to the interprofessional team and employ a well-coordinated, team approach to assisting in the preparation and intubation of patients.

Author(s) / Contributors Disclosure of Conflicts of Interest

Each author, editor, faculty and planning committee member have completed a disclosure form indicating that neither they nor their spouse/partner has a financial interest/arrangement or affiliation that could be perceived as a real or apparent conflict of interest related to the content of this activity.

COMMERCIAL SUPPORT: This activity has received NO commercial support.

Continuing Education Accreditation Information

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Quillen College of Medicine, East Tennessee State University, and StatPearls, LLC. The Quillen College of Medicine, East Tennessee State University is accredited by the ACCME to provide continuing medical education for physicians.

Quillen College of Medicine, East Tennessee State University designates this activity for a maximum of 1.00 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This activity is reported to the following Maintenance of Certification (MOC) boards:
American Board of Anesthesiology
  • Ambulatory/Outpatient
  • General Operative Anesthesia
  • Trauma
American Board of Internal Medicine
  • Critical Care Medicine
American Board of Otolaryngology
  • General Otolaryngology
American Board of Pediatrics
  • Pediatric Critical Care Medicine
American Board of Surgery
  • General Surgery

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  1. Register for the activity and create a StatPearls login.     
  2. Review the required accreditation information:  Target audience, learning objectives, and disclosure information.
  3. Complete the entire self-study activity.
  4. Complete the post-test assessments.
  5. Successfully pass the post-test with a minimum score of 100%.
  6. Complete the evaluation survey. 
  7. Obtain a certificate.

StatPearls and ETSU adhere to ACCME Standards regarding commercial support of continuing medical education. It is the policy of StatPearls and ETSU that the faculty and planning committee disclose real or apparent conflicts of interest relating to the topics of this educational activity, that relevant conflict(s) of interest are resolved, and also that authors and editors will disclose any unlabeled/unapproved use of drug(s) or device(s) during their presentation. Detailed disclosure will be made prior to starting the activity.

The information provided at this CME/CE activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

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    Deborah Z. on 1/6/2021

    Alvar D. on 1/27/2021

    Regina B. on 2/3/2021

    Darcey A. on 2/13/2021

    very good review

    NASAR S. on 3/9/2021

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    Rene G. on 12/28/2021

    Good additions to the traditional airway exam. Thanks. One question is weird, where an anesthetist tries to intubate an adult female using 100 mcg of fentanyl. I know no anesthetist who would attempt intubation with such an inadequate dose of medication. Seems odd.

    Androcles L. on 12/28/2021

    Cherie T. on 12/28/2021

    Engy H. on 12/31/2021

    SREEDEVI Y. on 1/1/2022

    Debra F. on 1/3/2022

    I found STATPEARLS a good resource till now (I have read only one subtopic by now after joining) for my goals of passing USMLE with highest percentile and EPIC with high credits.

    DR. SCIDDHARTHA K. on 1/4/2022

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