“Cannot Intubate, Cannot Oxygenate” (CICO) rescue by emergency Front of Neck Airway (eFONA)

In airway management, a ``Cannot Intubate, Cannot oxygenate” emergency, or simply ``CICO” (IPA: kaɪkəʊ), is an inability to restore alveolar oxygenation by means of any non-surgical lifeline (facemask, endotracheal tube, or supraglottic airway device). With ``CICO,” hypoxic brain damage and death will result unless there is rapid resolution. The ability of an airway team member to swiftly establish an emergency Front of Neck Airway as a CICO rescue is currently deemed to be an essential skill for everyone that performs tracheal intubations. This paper presents the context, components, justification, and human factors-related ramifications of a simple rescue cricothyroidotomy technique currently favored in many institutions and commended in guidelines internationally, particularly in the context of a cognitive tool, the Vortex Approach to airway management.