Lost in transition: the challenges of getting airway clinicians to move from the upper airway to the neck during an airway crisis

Br J Anaesth. 2020 Jul;125(1):e38-e46. doi: 10.1016/j.bja.2020.04.052. Epub 2020 May 28.


Technical and psychological factors make performance of an emergency front-of-neck airway (eFONA) a challenging procedure for clinical teams involved in airway management. When 'cannot intubate, cannot oxygenate' (CICO) emergencies occur, eFONA is frequently performed too late or not at all. The concept of transition to eFONA comprises simultaneous efforts to prevent and prepare for eFONA before a declaration of CICO in an effort to facilitate its timely and effective implementation. Although such a transition represents an appealing idea, attention to many aspects of airway practice is required for it to become an effective intervention.

Keywords: airway emergencies; airway management; cannot intubate cannot oxygenate; difficult airway; emergency front-of-neck airway; emergency surgical airway; transition.

Publication types

  • Review

MeSH terms

  • Airway Management / instrumentation*
  • Airway Management / methods*
  • Airway Management / psychology
  • Emergencies
  • Humans
  • Larynx
  • Neck
  • Trachea