George Kovacs

Biographical Timeline

• 1983 – BSc, Dalhousie University, Halifax, Nova Scotia.
• 1989 – MD, Dalhousie University.
• 1995 – Fellowship of the Royal College of Physicians and Surgeons of Canada in Emergency Medicine (FRCPC).
• 1999 – Master of Health Professions Education (MHPE), University of Illinois Chicago.
• 2007 – With J. Adam Law, edited the first edition of Airway Management in Emergencies, a multidisciplinary emergency-airway textbook
• 2018 – With Richard Levitan and Rob Sandeski, published Clinical Cadavers as a Simulation Resource for Procedural Learning
• 2020 – With Richard Levitan, published Redirecting the Laryngoscopy Debate and Optimizing Emergency Airway Management, developing concepts of laryngoscopic geometry and device delivery relevant to hyperangulated video laryngoscopy.
• 2020 – Received the Canadian Association of Emergency Physicians President’s Award, CAEP’s highest honour for service to emergency medicine.
• 2021 – Contributed to the Canadian Airway Focus Group difficult-airway recommendations for both unanticipated and anticipated difficult airway management. Received the Emergency Health Services Long Service Award recognising 25 years of service.
• 2022 – Co-authored the international Project for Universal Management of Airways (PUMA) consensus guideline on preventing unrecognised oesophageal intubation.
• 2023 – Awarded the Queen Elizabeth II Platinum Jubilee Medal (Nova Scotia).
• 2025 – Received the Dalhousie Centre for Teaching and Learning Academic Innovation Award with Anna MacLeod and Rob Sandeski for work in medical education and clinical cadaver learning.
• 2026 – Co-editor, with J. Adam Law and Andrew Parks, of the open-access Airway Management in Emergencies – Infinity Edition.
• 2026 – Contributed to PUMA international guidelines on the foundations of airway management and tracheal extubation, and continued involvement in national and international airway guideline development.
• Current – Professor of Emergency Medicine at Dalhousie University with cross-appointments in Anaesthesia, Medical Neurosciences, and Continuing Professional Development and Medical Education. Medical Director of EHS LifeFlight and Dalhousie’s Human Body Donation Clinical Cadaver Program; Co-Director of Airway Management & Interventions in Emergencies (AIME).

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Medical Eponyms

Kovacs sign (2015)

Kovacs sign describes excessive insertion and rotation of a hyperangulated video laryngoscope blade. The resulting close-up view shows the glottis filling much of the screen, with the anterior subglottic wall, cricoid or proximal tracheal rings visible through the vocal cords. Although the laryngeal view may appear excellent, the resulting steep angle creates unfavourable geometry for endotracheal tube delivery.

The sign arose from Kovacs’ airway teaching and was named by Richard Levitan, who attributed the finding to Kovacs in 2015. Recognition of the sign prompts slight withdrawal and de-rotation of the blade, accepting a more restricted glottic view that provides greater space for tube delivery and better alignment with the long axis of the trachea.

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Key Medical Contributions

Airway Management & Interventions in Emergencies (AIME). Kovacs co-founded AIME with Canadian anaesthesiologist J. Adam Law as a multidisciplinary programme dedicated to the practical management of emergency and difficult airways. The programme has developed from structured airway courses into advanced clinical-cadaver training, awake-intubation programmes, international teaching and open-access educational resources.

Emergency airway management. Kovacs’ broader clinical and academic work has addressed difficult and failed airway management, awake tracheal intubation, video laryngoscopy, bougie use, prevention of unrecognised oesophageal intubation, physiologically difficult airways and airway management outside the operating theatre.

His contributions span clinical research, procedural education, textbooks and national and international guideline development, including work with the Canadian Airway Focus Group and Project for Universal Management of Airways (PUMA).

Video laryngoscopy and laryngoscopic geometry. Kovacs has contributed to the development of practical approaches to video laryngoscopy, particularly the distinction between obtaining a maximal glottic view and achieving favourable geometry for endotracheal tube delivery.

Critical care transport and prehospital airway management. As Medical Director of EHS LifeFlight, Nova Scotia’s provincial critical care transport programme, Kovacs teaches on airway management including prehospital, transport, remote and physiologically difficult airway environments.

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Selected Major Publications [Full bibliography]

• Kovacs G, Law JA, McCrossin C, Vu M, Leblanc D, Gao J. A comparison of a fiberoptic stylet and a bougie as adjuncts to direct laryngoscopy in a manikin-simulated difficult airway. Ann Emerg Med. 2007 Dec;50(6):676-85
• Gu Y, Robert J, Kovacs G, Milne AD, Morris I, Hung O, MacQuarrie K, Mackinnon S, Adam Law J. A deliberately restricted laryngeal view with the GlideScope® video laryngoscope is associated with faster and easier tracheal intubation when compared with a full glottic view: a randomized clinical trial. Can J Anaesth. 2016 Aug;63(8):928-37
• Kovacs G, Levitan R, Sandeski R. Clinical Cadavers as a Simulation Resource for Procedural Learning. AEM Educ Train. 2018 Jun 6;2(3):239-247.
• Kovacs G, Levitan R. Redirecting the Laryngoscopy Debate and Optimizing Emergency Airway Management. Acad Emerg Med. 2020 Dec;27(12):1366-1369.
• Law JA, Kovacs G. Videolaryngoscopy 2.0. Can J Anaesth. 2022 Apr;69(4):409-415. 
• Chrimes N, Higgs A, Hagberg CA, Baker PA, Cooper RM, Greif R, Kovacs G, Law JA, Marshall SD, Myatra SN, O’Sullivan EP, Rosenblatt WH, Ross CH, Sakles JC, Sorbello M, Cook TM. Preventing unrecognised oesophageal intubation: a consensus guideline from the Project for Universal Management of Airways and international airway societies. Anaesthesia. 2022 Dec;77(12):1395-1415.
• Parks A, Law JA, Kovacs G. Wake up!: a novel, cadaver-based approach to training emergency physicians in awake intubation. CJEM. 2025 Feb;27(2):107-110. 
• Kovacs G, Law JA, Parks A, eds. Airway Management in Emergencies: Infinity Edition. 2026. [Open access]
• Chrimes NC, Higgs A, Greif R, Baker PA, Cooper RM, Hagberg CA, Kovacs G, Law JA, Myatra SN, O’Sullivan EP, Rosenblatt WH, Ross CH, Sakles JC, Sorbello M, Marshall SD. Project for Universal Management of Airways: guidelines for providing a foundation for airway management. Anaesthesia. 2026 Aug 27.

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References

Biography

• Interviews with George Kovacs November 2026

Eponymous terms

• Weingart SD, Barnicle RN, Janke A, Bhagwan SD, Tanzi M, McKenna PJ, Bracey A; Resuscitationists Research Group. A taxonomy of key performance errors for emergency intubation. Am J Emerg Med. 2023 Nov;73:137-144
• Boyd R, Dinsmore J. Hyperangulated videolaryngoscopy. Australasian Anaesthesia. 2025:83–95.
• Hung TY, Su YC, Yu SH, Li SS, Chen HL, Ho GJ, Lee CW, Tsai CY. Comparison of intubation techniques using standard geometric videolaryngoscope with bougie, hyperangulated videolaryngoscope, and videostylet in cadavers with only epiglottis visible. Sci Rep. 2025 Oct 30;15(1):37963