This video demonstrates how this might look in real-time during an airway crisis. The staff already know one another so names/roles aren't declared. Note slightly different Vortex terminology in this era (optimal attempt = best effort, ESA status = Priming Status)

When help arrives at an airway emergency the responsibility to communicate key information is shared by both the operator & arriving help - but the help may be better cognitively placed to ensure this occurs. Actively seek the following info when attending an airway crisis.

A 'best effort' at any upper airway lifeline (FM, SGA, TT) should incl an attempt with full NM blockade Intubation wout NMB ⬆️ trauma & ⬇️ success NMB ⬆️ success w FM & SGA NMB also provides optimal conditions for neck rescue vortexapproach.org/lifelines… sciencedirect.com/science/ar…

"Sniffing position" = BOTH base of neck flexion & AO extension (=> #Flextension per @doctimcook) Torso elevation helps ⬆️ FRC, ease of PPV & may be necessary to achieve flextension if high BMI. Ramping = flextension + torso elev vortexapproach.org/lifelines… sciencedirect.com/science/ar…

A 'best effort' at facemask ventilation should always include a 2-handed attempt using "vice grip". vortexapproach.org/lifelines… sciencedirect.com/science/ar…

'Priming' refers to escalations in readiness to perform neck rescue undertaken BEFORE a neck rescue emergency arises, to minimise delays to restoring O2 delivery. Priming status tool provides a structured approach to this. sciencedirect.com/science/ar… VortexApproach.org/cico#cico…

The Vortex airway rescue cart integrates presentation of equip w the Vortex so that it becomes an extension of the cognitive aid, prompting performance. More info on HF based airway carts in @Anaes_Journal: associationofanaesthetists-p… Create your own free: VortexApproach.org/airwaycar…

Turning a plan into a strategy requires repeatedly asking "What is the plan if that plan fails?" Each component plan in the strategy should address optimising lifelines, degree of priming for neck rescue & appropriate actions if the Green Zone is entered vortexapproach.org/planning

Inability to intubate is an inconvenience. Inability to ventilate is a crisis. Repeated airway instrumentation can convert a "can ventilate" situ into a "can't ventilate" situ. When ventilation is possible, use the opportunities of the Green Zone before reinstrumenting the aw.

Find the answer at VortexApproach.org