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Amplification & Escalation

a nextgen learning space designed to elevate your airway practice

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improve the signal to noise ratio

Oxygenation by any means necessary is our objective. When other methods have failed we need to perform FONA.

But when that moment arrives, will we be able to cut through the noise in time to act? In the chaos of a resuscitation, we need a way to amplify the signal that CICO is here and the time is now.

Improving that signal to noise ratio is the next step on our journey to cultivate a FEARLESS FONA MINDSET.

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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.

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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

EMUpdates on the double setup

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


WHAT’S NEXT

For in person learners, locate any of the posters below within the installation to continue your training. Then snap the QR codes embedded within them to access the learning space. Look for the ✋emoji for integrated hands on training opportunities.

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