“Calm in crisis. Clear in method. Prepared in mind. Steady in hand.”
Course Description
- Description: The Fearless FONA Training Program
- Creator: Jonathan St George, MD
- Includes: Online + Hands-On Curriculum
- Completion Time: 30-45 minutes (not including simulation)
- CME & Certificate available: Yes (with site subscription)
FONA is the quintessential HALO airway procedure. It is rare, time‑critical, and unforgiving of hesitation, and success depends far more on recognition, cognition, and decision‑making than on technical difficulty alone. Every HALO domain applies: seeing the threat early, keeping the mind online under stress, knowing when a threshold has been crossed, aligning the team with clear language, and learning deliberately from each exposure. In this space, we introduce the elements of the FEARLESS FONA Mindset—human‑centered principles, combined with the essential ingredient of regular practice, that prepare you to meet this moment with clarity, decisiveness, and control when it matters most.
Click Here & Dive Deeper in the HALO Domains
FONA as the Quintessential HALO Procedure
A concise conceptual map of the Fearless FONA ecosystem organized around the Five HALO Domains. This is the backbone. No excess.
Click below for a deeper dive into the HALO Program.
DOMAIN I — Threat Recognition
Seeing the danger before hypoxia decides for you.
- Failure in FONA almost never starts with the cut. It starts with late recognition.
- Tools such as CricCon, the improbable airway concept, and early CICO declaration exist to amplify weak signals before they are obscured by noise, bias, or false reassurance.
- Threat recognition is not about counting attempts. It is about recognizing the combination of low likelihood of success and rising physiologic risk.
Bottom line: Recognize the moment when delay becomes harm.
DOMAIN II — Cognitive Control
Keeping the mind online when stress peaks
- Acute stress reliably produces attentional narrowing, working memory collapse, and threat rigidity.
- Cognitive control is preserved through simplicity, pre-commitment, and rehearsal, not willpower.
- Reframing failure (failed intubation ≠ clinician failure) prevents paralysis and decision freeze.
Bottom line: Fear is normal. Losing cognitive control is optional if systems are built for humans.
DOMAIN III — Threshold Decisions
Knowing when action is mandatory
- Strategy gets you to the neck on time. Tactics only matter after that.
- Planning bridges intent and execution by defining when to stop optimizing and start rescuing.
- Early commitment to FONA, the double setup, and limiting futile attempts prevent time theft by indecision.
Bottom line: The hardest decision in FONA is not how to cut, but when.
DOMAIN IV — Teamwork & Communication
Aligning humans under compression
- FONA is a team performance, not a solo technical act.
- Critical language (CICO), role clarity, and amplification–escalation create shared mental models.
- Teams that train together move faster, speak less, and hesitate less.
Bottom line: If the team is not aligned, the airway will not be rescued in time.
DOMAIN V — Recovery, Aftermath, Learning
What determines performance next time
- Performance does not end when oxygen returns.
- Cognitive residue, emotional processing, and structured debriefing determine whether learning occurs or fear calcifies.
- Deliberate, distributed practice converts a rare catastrophe into a rehearsed response.
Bottom line: You do not rise to the occasion. You fall to the level of your preparation and reflection.
Final Synthesis
FONA mastery is not a procedure problem. It is a recognition, cognition, decision, communication, and learning problem that culminates in a scalpel. The Five HALO Domains are how you solve it—before the neck ever needs to be cut.
Learning Objectives
Start the Course: Visit the Posters
A Visual Gateway to Deeper Learning
The emergency surgical airway is a simple procedure, but one of the hardest to perform under pressure. Why? Because fear, hesitation, and human factors often stand in the way. In this space, we break down those barriers. We dismantle the myth that FONA has to be terrifying and help you build a FEARLESS FONA MINDSET—one that thrives in the heat of a can’t intubate, can’t oxygenate crisis.
Through storytelling, immersive, interactive content, you’ll explore every critical element of successful FONA. You’ll sharpen your technical skills, confront the human factors, and develop the confidence to act without hesitation. When that high-stakes moment comes, you’ll be ready, not frozen. If you want to be the clinician who delivers when it counts, this is where it starts.
Scroll down. Let’s get to work. 👇💪
Chapter 1
a better way
Take the first step towards the cultivation of a Fearless FONA Mindset.
Chapter 2
The necessary elements
Learn about the key elements that must be considered for a successful FONA.
Chapter 3
The first element
Human factors are among the most significant barriers to performing FONA. Some of them may surprise you. Learn how to overcome them here. Yes, it’s time to rewire your brain.
Chapter 4
The second element
In a stressful and time-dependent environment, you need to cultivate simplicity. Explore this critical element and use it to create an elegant and minimalist approach to the CICO scenario.
Chapter 5
The third element
FONA is a straightforward procedure, but the path to its successful implementation has many pitfalls. Knowing the failed airway algorithm is not enough. You need an actionable plan. Learn the strategy and tactics that make up another critical element of cultivating your fearless FONA mindset.
Chapter 6
the fourth element
Time inevitably erodes our skills. So, how do we stay prepared for this high-stakes, low-frequency event? The cultivation of regular practice. Get started here.
Bring This Training to You
Build Your Own Training Lab
Turn any space into a hands-on airway training zone. Grab our posters and your gear, and follow a few simple steps.
What’s Next
You could stop here, but why would you want to? You have the entire universe of online immersive and interactive learning spaces here. If you’re with us in person at one of our live events, courses, or pop-up learning spaces, use the enhanced digital content for hands-on training, skills development, and expert coaching for next-generation learning designed to elevate your airway practice.
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Meet the Creators
JOnathan St George MD
Jonathan St. George is an Emergency Medicine attending at Weill Cornell University in New York City. He is the creator behind the methodology for PAC with a lifelong interest in airway management and MedEd innovation with the goal of improving how we learn.
Jason HIll MD
Jason Hill is an Emergency Medicine attending at Columbia University and holds a long-term interest in design. This interest began during his PhD years where he developed software to reconstruct 3D models from brain MRI scans to study cerebral development. He has since made a foray into 3D design, 3D printing, and virtual reality to create novel medical training tools. It is his firm belief that these new technologies will allow for innovative and accessible new avenues to train the next generation of medical practitioners.
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