“Pick Up a Knife, Save a Life”: Emergency Front-of-Neck Airway for the Non-Surgeon Clinician

AbstractPurpose of ReviewProficiency obtaining an emergency front-of-neck airway (eFONA) is a requirement of all advanced airway managers. The aim of this review is to discuss a single, ideal eFONA technique for non-surgeon clinicians faced with “can’t ventilate, can’t oxygenate” (CVCO) scenarios. We intend to identify potential pitfalls of the suggested technique and to provide practical strategies to optimize procedure success in crisis.Recent FindingsIdentification of the cricothyroid membrane via solely external palpation has been shown to be unreliable, particularly in the obese and in females irrespective of BMI.SummaryFor non-surgeon clinicians faced with a CVCO crisis, the vertical incision scalpel-finger-bougie technique is recommended in all adult patients. Airway managers should recognize the potential for a CVCO trajectory with the recognition of two cognitive “trigger events”: the absence of waveform capnography and hypoxia. Optimization of human factors is an essential component of safe care in any airway emergency.

Source: Current Anesthesiology Reports - July 17, 2021 Category: Anesthesiology Source Type: research