amplification & escalation defined

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 and a series of responses that escalate FONA through rehearsed actions will help 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 by 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 the 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.