The emergency surgical airway

Discussions about emergency surgical airway or front of neck access (FONA) can provoke vigorous debate and strike fear into the hearts of air- way clinicians. The 'can’t intubate, can’t oxygenate' (CICO) situation requires prompt and decisive action, and it is important that all clinicians performing advanced airway interventions have a well-considered plan for this rare scenario. Due to the nature and infrequency of CICO events, evidence is largely limited to case series, synthetic models, live animal models and cadaveric human studies. Consensus opinion predominates. In this article, we attempt to draw on the currently available evidence and recently published CICO guidelines to answer common questions that emergency airway practitioners might encounter. Our aim is to provide and justify simple recommendations for this high-stakes emergency situation