PAC:SCAPEExhibit 05 / Perform
PAC:SCAPE // EXHIBIT 05 // Practice

The Element of Practice

Protect a low-frequency skill through anatomy, mechanics, repetition, and deliberate rehearsal.

Exhibit premiseTime erodes skill. Practice restores access.
Play firstNarrated from the ancient Fearless FONA manuscripts.
Orientation film
QR arrival // Start hereBegin here before exploring the Gallery or entering the Practice Studio.After the film: explore the Gallery ↓
Exhibit 05

Review briefly. Then put the instruments in your hands.

Six Gallery Rooms hold the anatomy, demonstrations, and technique review. Four Studio tasks guide a complete procedure, repair, optional timing, and ten repetitions.

Gallery / Rooms 01–06Explore the GallerySkill decay · anatomy · whole procedureStudio / Practice 01–04Enter the Practice StudioPerform · repair · time · repeat
Gallery 05Rooms
Room 01Gallery study

Regular practice

Time erodes all skills.
Practice restores access.

Emergency front-of-neck access is a high-stakes, low-occurrence procedure. Clinical work may not provide enough repetitions to keep the sequence readily available. This space supplies the practice the rare event cannot.

The emergency cannot be the rehearsal.

Return to the station between cases. Each visit should make the sequence easier to retrieve and less dependent on a prompt.

Continue to the anatomical map →
An illustrated manuscript showing a clinician recording anatomy as time erodes a rarely used skill.
Study 01 // A rarely used skill still changes with time.
Room 02Gallery study

Anatomy refresh

Refresh the anatomical map before the clock starts.

This is a refresher, not a second anatomy course. Re-establish the surface landmarks and the midline working plane before you pick up the scalpel.

Anatomy orientation // Start here

What the eyes can’t see, the fingers must find.

The relevant anatomy lies just beneath the surface. Large necks, excess tissue, or blood can often obscure these structures from view. Much of the critical anatomy is felt, not seen. Learn to trust your fingers.

Tactile map

Move from thyroid cartilage to cricoid.

Stabilize the laryngeal framework. Work downward until the finger identifies the springy membrane between the two firm cartilages.

An extended neck with the thyroid cartilage, cricoid cartilage, and cricothyroid membrane identified as surface landmarks.
Surface study // Work from the outside inward.
01
Thyroid cartilage

Find the upper frame.

02
Cricothyroid membrane

Keep the working plane in the midline.

03
Cricoid cartilage

Use the lower landmark as the backstop.

Built-in safety

Stay midline. Know the backstop.

The midline working plane avoids the major lateral neurovascular structures. The posterior plate of the cricoid provides a firm backstop beneath the entry site. This geometry does not remove risk; it explains why staying midline matters.

The Midline Principle illustration showing the cricothyroid membrane and the central working plane.
Midline study // Preserve the central working plane.
An illustrated study of the cricoid cartilage showing its anterior arch and posterior plate.
Backstop study // Understand the geometry behind the target.
Carry forward

Find the thyroid cartilage. Find the cricoid cartilage. The membrane lies between them. Trust the map, then confirm it with your hands in the Practice Studio.

Room 03Gallery study

Whole procedure

Watch the whole procedure once.

Follow one continuous event from first touch to oxygen delivery. The station will slow the sequence down and attach it to the movements of your hands.

Optional case shelfSee the procedure under pressure
Quick review // Watch without interruption
  1. 01Position
  2. 02Palpate
  3. 03Incise
  4. 04Enter
  5. 05Guide
  6. 06Secure
  7. 07Oxygenate

Carry this order forward. Use the following Rooms for a closer study, or begin physical practice in the Studio.

Room 04Gallery study

Guided sequence

See how the phases join.

Use the walkthrough to study the order and transitions. Then return to the trainer and perform the sequence.

Study the four phases

Watch how one phase leads into the next. Pause to study the movement that needs closer attention.

  1. 01Expose & Palpate
  2. 02Cut & Enter
  3. 03Confirm & Guide
  4. 04Deliver & Secure
Practice Studio / Task 01Return to perform the sequence →
Room 05Gallery study

Technique repair

Study the movement that interrupted you.

Open the phase that needs attention. Review the technique, then return to the same practice task.

01
Expose & PalpatePosition the neck and establish the landmarks.
Extend the neck skills card.Laryngeal handshake skills card.
Extend the Neck

Create access to the anterior neck.

Laryngeal Handshake

Find and stabilize the laryngeal framework.

Hand Position

Keep the stabilizing hand low on the thyroid cartilage.

02
Cut & EnterCreate and confirm the path into the airway.
Long vertical incision skills card.Horizontal incision skills card.
Hold the Scalpel

Set the grip before the first cut.

Long Vertical Incision

Open a generous midline working field.

Confirm the CTM

Re-establish the membrane after the skin incision.

Horizontal Incision

Enter the membrane and maintain the opening.

03
Confirm & GuideReplace vision with touch and keep the tract controlled.
Finger in the Hole

Use the finger to confirm and preserve the tract.

Insert the Bougie

Guide the bougie past the finger and into the trachea.

04
Deliver & SecureComplete the airway and connect it to oxygen.
Railroad the Tube

Advance the tube over the bougie without losing the tract.

Remove the Bougie

Hold the tube in place as the bougie leaves.

Inflate the Cuff

Secure the airway and prepare to oxygenate.

Practice Studio / Task 02Return to repair a hesitation →
Room 06Gallery study

Repetition demonstration

Watch one complete practice set.

Challenge demonstrationDr. Levitan performs 10 crics in under 10.Vertical video // 9:16

Dr. Levitan demonstrates the ten-repetition challenge. Notice the setup and the return to the beginning of each procedure.

In the Studio, count complete procedures through simulated oxygen delivery. Under ten minutes remains a practice target.

Practice Studio / Task 04Return to rehearse ten →
Time to Practice: Fearless FONA physical practice poster.Scan to open the Fearless FONA Practice Studio instructions on the PAC website.
Time to Practice / Fearless FONA. Poster supplied by PAC.
Studio introduction / Victor Lau

Your practice session

0:00 / –:––

Read transcript →

Fearless FONA / Practice Studio

Put the procedure into your hands.

Set the device beside the trainer. Lay out the equipment.

Trainer · Scalpel · Bougie · Tube
Ten skin analogues

Begin practice 01 →

Equipment within reach. Follow the station’s handling and reset instructions. Missing something? Ask the educator before starting.

Count complete procedures through simulated oxygen delivery. Timing is a practice cue, not a competency assessment.

01
Practice 01 / Learn the sequence

Perform one complete procedure.

1Expose & Palpate
2Cut & Enter
3Confirm & Guide
4Deliver & Secure

Set the field

Equipment within reach. Device beside the trainer.

Run the whole sequence

First touch → simulated oxygen delivery. No visual prompt.

Guided audio resource

One run with the guide. Pause it. Repeat unaided.

0:00 / –:––

Scalpel · Finger · Bougie · Tube. If audio fails, follow the written cues above.

FinishOne complete, unaided procedure.
Retry

Name the phase where you stopped. Review it, then run the whole sequence again.

Review the sequence in the Gallery →Practice 02: repair a hesitation →
02
Practice 02 / Refine the movement

Find the interruption. Work on that movement.

Run

Perform the whole procedure.

Name & repair

Identify the hesitation. Repeat that movement.

Reset & repeat

Follow the station reset. Run again without prompts.

FinishThe repaired movement fits into one continuous procedure.
Retry

Work on the interruption before adding speed.

Review technique in the Gallery →Practice 03: time one procedure →
03
Practice 03 / Optional timing

Time one complete procedure.

Start → perform → stop

Start at first touch. Stop at simulated oxygen delivery.

Practice target Under 60 seconds

Performance stopwatch00.0Seconds // Start → oxygen deliveryTarget < 60.0

Temporary stopwatch. Leaving or refreshing clears it.

FinishThe full sequence is complete; the clock is stopped.
Retry

If the sequence breaks, repair the movement before timing another run.

Practice 04: rehearse ten →
04
Practice 04 / Repetition

Ten complete procedures. One repeatable sequence.

01020304050607080910

Prepare ten

Ten skin analogues. All equipment within reach.

Perform → reset → repeat

Follow the station’s reset between attempts.

Count complete procedures

Count only at simulated oxygen delivery.

FinishTen full repetitions. Under ten minutes remains the practice target.
Retry

Repair a broken sequence before starting another set.

Optional clock and manual repetition record

Challenge instrument

Ten repetitions. One clock.

Tap Cric complete at oxygen delivery. Each tap records the split and advances the wall.

This is your self-reported practice record, not a competency assessment. It lasts only while this page stays open. Gallery links leave this page and clear the record; refresh, back, and closing the page also clear it. Finish or note your times before leaving.

Time remaining10:00.0Target // 10 complete before 00:00.0
Repetition00/10Large touch target · Space bar also records
  1. 01—
  2. 02—
  3. 03—
  4. 04—
  5. 05—
  6. 06—
  7. 07—
  8. 08—
  9. 09—
  10. 10—
ReadySet the field. Start when your hands are ready.
Review the challenge in the Gallery →
Before you leave

Reset the physical station.

Follow the station’s instructions for the trainer, used skin analogues, scalpel, bougie, and tube. Ask the educator if the required reset is unclear. Leave the equipment in its designated starting arrangement.

Clearing a digital timer does not reset the physical station.

Return to the Exhibition Map →

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