It is often believed that a failure to intubate is the same as a failed airway. This is not the case. It is a failure to oxygenate by the use of all your upper airway lifelines that defines a failed airway. This is why the critical language that should trigger FONA is “can’t intubate & can’t oxygenate” rather than just “can’t intubate.”

While exigent circumstances may lead you to declare a failed airway before completing a best effort at all your upper airway lifelines, in general, it is the inability to oxygenate that defines failure.

If for example you can provide adequate oxygen to your patient with a face mask ventilation or a supraglottic airway you have time to consider other options to deliver a definitive airway and a declaration of a failed airway can be deferred until such time as oxygenation becomes compromised or it is determined that placement of an endotracheal tube is impossible.