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The Art of FONA Strategy

nextgen learning to elevate your airway practice


IntroductionSignal to Noise
CICO SignalWhat’s Next


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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.

Stay Above the Noise

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 escalates 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 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.

The CICO Signal

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.


To Be Completed

What’s Next

Tools & Techniques

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