Role of Ultrasound in Emergency Front of Neck Access: A Case Report and Review of Literature

A A Pract. 2019 Nov 15;13(10):382-385. doi: 10.1213/XAA.0000000000001089.


Emergency front of neck access (eFONA) is a lifesaving procedure in a cannot intubate cannot oxygenate (CICO) situation. We report a case of a patient who presented to the emergency department (ED) in extremis with a difficult airway. A history of multiple neck surgeries and permanent tracheostomy from birth until the age of 17 years complicated his airway management. Altered neck anatomy led to failed intubation and oxygenation. EFONA was established with the use of rapid ultrasound imaging and using the scalpel-bougie-tube technique. We present a review of literature relating to the use of ultrasound during emergency airway management.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Emergency Medical Services / methods*
  • Humans
  • Intubation, Intratracheal / instrumentation*
  • Lymphangioma, Cystic / complications*
  • Lymphangioma, Cystic / surgery
  • Male
  • Tracheostomy / instrumentation*
  • Treatment Outcome