Emergency surgery anesthesia is performed in an extremely time-critical and high-risk setting, where delayed or inaccurate assessment may lead to severe perioperative complications. Patients often present with hemodynamic instability, limited preoperative information, and complex comorbidities, creating major challenges for anesthesiologists to rapidly evaluate airway, circulation, and physiological reserve. Although multiple assessment tools exist, conventional approaches remain fragmented and insufficient for dynamic, real-time decision-making in emergency contexts. There is a clear need for an integrated rapid anesthesia assessment framework that combines advanced monitoring, intelligent decision support, and team-based coordination. This perspective article systematically analyzes rapid assessment models that integrate multimodal point-of-care ultrasound, artificial intelligence–assisted regulation, and closed-loop clinical decision support system (CDSS) protocols. Key applications in perioperative airway management, hemodynamic and respiratory assessment, and risk stratification for special populations, including elderly and pediatric patients, are discussed. We further summarize the rapid titration and hemodynamic advantages of novel anesthetic agents in emergency induction, the role of CDSS and closed-loop communication in clinical emergency management, and the optimization of team collaboration using standardized tools such as Situation–Background–Assessment–Recommendation. Ethical and legal considerations, including informed consent, presumed consent, and proxy decision-making in time-sensitive scenarios, are also addressed. Overall, integrated rapid assessment strategies supported by technology, interdisciplinary teamwork, and ethical safeguards may substantially enhance the safety, efficiency, and clinical outcomes of anesthesia management in emergency surgery, providing a practical framework for future perioperative practice and multicenter validation.

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