COPUR Pediatric Airway Score

This project provides an evidence-based digital tool to assess pediatric airway difficulty using the COPUR scoring system. It standardizes evaluation, reduces human error, and supports clinical decision-making.

The COPUR score includes five evidence-based airway predictors. Each component is scored from 0 to 3, producing a total score between 0 and 15.

• C

  Congenital Abnormality

  0 = None · 1 = Minor · 2 = Moderate · 3 = Severe

• O

  Airway Obstruction

  0 = None · 1 = Mild · 2 = Moderate · 3 = Severe

• P

  Respiratory Pathology

  0 = None · 1 = Mild · 2 = Moderate · 3 = Severe

• U

  Uvula Visibility

  0 = Fully visible · 1 = Partially visible · 2 = Barely visible · 3 = Not visible

• R

  Restricted Mouth Opening

  0 = Normal · 1 = Mild · 2 = Moderate · 3 = Severe

The total score is interpreted using validated risk ranges. A score of 7 or higher is supported by evidence as a predictor of difficult intubation.

The app provides clinical recommendations based on the risk category, including:

• Airway equipment needed
• Level of provider required
• Anesthesia considerations
• Preparation steps
• Backup airway plans

These recommendations follow pediatric airway guidelines and validated research.

This tool is intended to support clinicians in emergency, anesthesia, and critical care settings. It is not a replacement for clinical judgment but an evidence-based decision-support tool.

1. 1. Development and Validation of the COPUR Score for Predicting Difficult Airway in Children Aged 1–8 Years.

   Journal of Anaesthesiology Clinical Pharmacology, 2025.

2. 2. Difficult Airway Society (DAS) Pediatric Guidelines

   “Guidelines for the Management of the Difficult Pediatric Airway.” Anaesthesia, 2020.

   Used for: equipment lists, video laryngoscope recommendations, fiberoptic indications, surgical airway preparation.

3. 3. American Society of Anesthesiologists (ASA) Difficult Airway Algorithm

   “Practice Guidelines for Management of the Difficult Airway.” Anesthesiology, 2022 Update.

   Used for: anesthesia recommendations, avoiding paralytics, awake techniques, team briefing.

4. 4. Pediatric Airway Management Textbook

   Litman et al. “Pediatric Airway Management.” Cambridge University Press, 2019.

   Used for: mouth opening interpretation, uvula visibility relevance, congenital abnormality classification.

5. 5. Pediatric Obstruction Evidence

   “Airway Obstruction in Children: Clinical Severity and Management.” Pediatrics, 2018.

   Used for: mild, moderate, severe obstruction classification.

6. 6. Pediatric Respiratory Pathology Evidence

   “Respiratory Disease Severity and Airway Risk in Children.” Journal of Pediatric Pulmonology, 2021.

   Used for: asthma, bronchiolitis, pneumonia severity classification.