1887
Volume 2025, Issue 2
  • ISSN: 1999-7086
  • E-ISSN: 1999-7094

All challenging airway algorithms end with the situation of Cannot Intubate Cannot Oxygenate (CICO), which requires front of neck access (FONA) to secure a patent airway for the patient. The scalpel-bougie-tube is the standard technique recommended by difficult airway societies, which involves cutting the anterior neck with a surgical blade and making way for a 6-mm tube mounted over a bougie. This can be particularly challenging for anesthesiologists who have little experience with knives or this procedure in general. This is the primary reason FONA is executed late, even though the team is aware that it should be done. In this case report, we describe two cases (emergency and elective) in which we used the needle-catheter-wire technique with some modifications using Tritube to secure the airway and provide mechanical ventilation.

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References

  1. Cook TM, Woodall N, Frerk C; Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011May; 106:(5):617–31. https://doi.org/10.1093/bja/aer058
    [Google الباحث العلمي]
  2. Ince M, Melachuri V. Emergency front of neck access. Indian J of Respir Care. 2017Nov16; 6:(2):793–9. https://doi.org/10.4103/ijrc.ijrc_7_17
    [Google الباحث العلمي]
  3. Price TM, McCoy EP. Emergency front of neck access in airway management. BJA Educ. 2019Jun14; 19:(8):246–53. https://doi.org/10.1016/j.bjae.2019.04.002
    [Google الباحث العلمي]
  4. Apfelbaum JL, Hagberg CA, Connis RT, Abdelmalak BB, Agarkar M, Dutton RP, et al. 2022 American Society of Anesthesiologists Practice guidelines for management of the difficult airway. Anesthesiology. 2022Jan1; 136:(1):31–81. https://doi.org/10.1097/ALN.0000000000004002
    [Google الباحث العلمي]
  5. Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015Dec; 115:(6):827–48. https://doi.org/10.1093/bja/aev371
    [Google الباحث العلمي]
  6. Timmermann A, Chrimes N, Hagberg CA. Need to consider human factors when determining first-line technique for emergency front-of-neck access. Br J Anaesth. 2016Jul; 117:(1):5–7. https://doi.org/10.1093/bja/aew107
    [Google الباحث العلمي]
  7. Baker PA, O’Sullivan EP, Kristensen MS, Lockey D. The great airway debate: Is the scalpel mightier than the cannula? Br J Anaesth. 2016Sep; 117:Suppl 1:i17–9. https://doi.org/10.1093/bja/aew219
    [Google الباحث العلمي]
  8. Alhammad MF. Front of neck airway with tritube (FONAT): Does it replace tracheostomy? Trends Anaesth Crit Care. 2024Sep; 57::101405. https://doi.org/10.1016/j.tacc.2024.101405
    [Google الباحث العلمي]
  9. Vicker E. Finding upon inquest into the death of Richard Christopher JANKOWSKI. 2003.
    [Google الباحث العلمي]
  10. Greenland KB, Bradley WPL, Chapman GA, Goulding G, Irwin MG. Emergency front-of-neck access: scalpel or cannula—and the parable of Buridan’s ass. BJABritish Journal of Anaesth. 2017Jun; 118:(6):811–4. https://doi.org/10.1093/bja/aex101
    [Google الباحث العلمي]
  11. Foong WM, Wyssusek K, Culwick MD, van Zundert AAJ. Rising to the occasion – Institutional standardization and organization of equipment for “can’t intubate, can’t oxygenate” (CICO) crisis. Acta Anaesthesiol Belg. 2017; 68:(3):103–10. Available from: https://www.besarpp.be/wp-content/uploads/2021/04/03-foong.pdf
    [Google الباحث العلمي]
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  • نوع المستند: Research Article
الموضوعات الرئيسية airway controlFONAT cannot intubate cannot oxygenate Evonetracheostomy managementTritube Straw size tube and Ventrain endotracheal intubation

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