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

  • Airway Management (LC Berkow, Section Editor)
  • Published:
Current Anesthesiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Proficiency 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 Findings

Identification of the cricothyroid membrane via solely external palpation has been shown to be unreliable, particularly in the obese and in females irrespective of BMI.

Summary

For 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.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada

    Alexa Lynn Grudzinski & Laura Virginia Duggan

  2. Ottawa, Canada

    Alexa Lynn Grudzinski

  3. Ottawa Medical School, University of Ottawa, Ottawa, Ontario, Canada

    Alden Morgan

Authors
  1. Alexa Lynn Grudzinski
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  2. Alden Morgan
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  3. Laura Virginia Duggan
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Correspondence to Alexa Lynn Grudzinski.

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Grudzinski, A.L., Morgan, A. & Duggan, L.V. “Pick Up a Knife, Save a Life”: Emergency Front-of-Neck Airway for the Non-Surgeon Clinician. Curr Anesthesiol Rep 11, 355–362 (2021). https://doi.org/10.1007/s40140-021-00473-2

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  • DOI: https://doi.org/10.1007/s40140-021-00473-2

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