"Awake means awake." Completely agree. Preservation of spontaneous breathing efforts is the key to maintain oxygenation while the difficult airway is secured. Our PGY1 residents start learning with SAD -> awake Flexible videobronchoscopy ---> VL (C-MAC), in that order. It's very easy for the faculty to teach & correct them spot on with minimal risk of patient injury. It becomes so easy for them to learn to use DL after that.