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The Art of FONA Strategy

nextgen learning designed to elevate your airway practice

When that moment for FONA arrives, will you be able to act? To be successful you will need a strategy that will enhance your ability to successfully perform FONA in the stress and chaos of a resuscitation.

You need a strategy designed to amplify the signal that CICO is here and the time is now. Improving that signal to noise ratio is the next step on your journey to cultivate a FEARLESS FONA MINDSET.

amplification & escalation defined
a strategy to cut through the noise

The often insidious nature of a failing airway, is compounded by the fact that, as the cognitive “noise” increases, the required signal to trigger a team to act, may fall below the threshold needed to be received. A strategy that amplifies that signal combined with a series of responses that escalates FONA through rehearsed actions will help to ensure that you stay ahead of the curve.

Amplification: /amplifiˈkāSH(ə)n/ is the strategy deployed to ensure that the “signal” of a failing airway is not drowned out the “noise” of a chaotic, complex, and stressful airway emergency. Examples of amplification include verbalizing a FONA plan before each intubation, creating a shared mental model, or declaring CICO.

Escalation: /ˌeskəˈlāSH(ə)n/ involves the tactics deployed to mobilize resources and elevate the prioritization of FONA as a declaration of CICO approaches. For example, a predicted difficult airway, might prompt a team to palpate anatomy of the neck, mark the cricothyroid membrane, or bring equipment to the bedside. This escalation is itself an amplification of the signal – increasing the team’s situational awareness that rapid transition to FONA may be required.

staying ahead of the curve

Amplification & escalation are strategies and tactics that can be learned. Doing so ensures that the appropriate “signal” to perform FONA will remain above a threshold to overcome the impact an increasingly stressful and chaotic environment or “noise” will have on you and your team so you can continue to act effectively.

the bottom line

  • Amplification & Escalation ensures the signal to noise ratio during a difficult or failed airway remains above the critical threshold that triggers a timely performance of FONA.
clinical pearl

“Experienced emergency providers recognize procedural reserve as a luxury that the patient can revoke immediately and unpredictably…” — Reuben Strayer MD


You have taken another step towards cultivation of a FEARLESS FONA MINDSET. Continuing on the journey is as easy as visiting any of the posters in this element or clicking here to go to the online space.

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