NextGen Learning To Elevate Your Airway Practice
Essential Elements
Understand the True Nature of Simplicity
Getting to true simplicity means doing the hard work first. You face the uncertainty, the noise, the failure points, and the pressure—then deliberately refine it. What comes out the other side isn’t simple because it was easy. It’s simple because it’s been earned.
The Other Side of Complexity
This powerful quote by Oliver Wendell Holmes highlights the profound difference between naïve simplicity and genuine simplicity. It’s a distinction that lies at the heart of mastery in any field, and it’s especially relevant when it comes to front-of-neck access (FONA).
Holmes draws a line between two very different kinds of simplicity:
- Simplicity before understanding is a shallow, premature clarity. It skips over the hard work of grappling with complexity. It oversimplifies, ignores nuance, and leans on false confidence. It may feel easy, but it’s not useful, and certainly not safe. Holmes says plainly: “I wouldn’t give you a fig” for that kind of simplicity.
- Simplicity, after understanding, is earned. It’s a deep, refined clarity that only comes after you’ve engaged with the mess, fear, anatomy, time pressure, failure points, and uncertainty. This kind of simplicity is distilled from complexity, not divorced from it. It’s not simplistic—it’s essential. And it’s the kind of simplicity Holmes would give anything for.
To develop your Fearless FONA mindset, you must go through this same transformation. You must walk straight into the complexity, then do the hard, honest, repetitive work of turning that complexity into clarity.
Let’s begin.
How to Get There
If you want to develop true mastery in front-of-neck access (FONA), you have to do more than learn a technique. You have to design your way through the chaos until what remains is purposeful, clear, and resilient under pressure.
Much of the most recognizable work in simplicity, on the far side of complexity, has come from technology and design, rather than medicine. Think of Apple products: sleek, intuitive, almost effortless to use. However, that effortlessness is deceptive because it stems from a rigorous design discipline. Every curve, button, and screen flow has been tested, refined, and redesigned. The result isn’t just beautiful—it’s functional elegance born from complexity.
This is exactly the mindset needed to master FONA.
How to Apply Design Thinking
The principles of design thinking offer a practical path toward mastery:
- Empathize – Understand the reality of the problem. Feel what it’s like to be in a CICO moment. Acknowledge fear, time pressure, confusion, and tactile challenges.
- Define – Get specific: What exactly are you trying to solve? Is it speed? Decision paralysis? Landmarking? Equipment setup? Communication?
- Ideate – Brainstorm. Try new techniques, new language, new team roles, new kits. Don’t settle for what’s always been done.
- Prototype – Build systems: a FONA kit, a checklist, a script. Create something physical or procedural you can test.
- Test – Simulate. Run drills. Observe what fails under pressure. Debrief. Refine. Repeat.
Then do it again. And again. Until what remains is simple—but not simplistic.
Elegant ≠ Easy
When considering your approach to FONA, consider these four ways to achieve simplicity: design for clarity, minimize cognitive effort, limit options, and bridge what is often referred to as the gulf of execution.
Your final FONA approach should be so clear that your hands know where to go and your team knows what to expect—but only because you’ve gone through the hard work to get there.
It might look like:
- A neatly organized FONA kit that fits easily in your airway box.
- A team script with just three short commands
- A tactile flow that avoids visual dependency
- A consistent mental model: “Feel, stab, dilate, tube.”
That simplicity is not a shortcut—it’s a triumph. It’s the result of honoring the complexity, not avoiding it.
The Other Side of Complexity
Deep Cuts
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How to Apply Design Thinking
A Practical Guide to FONA Simplicity
Seeking Simplicity: Where to Begin
Let’s get to work on seeking simplicity in your FONA practice. Start by looking at every aspect of your approach to FONA through the lens of simplicity to find an economy and fluidity of action, from preparation to planning to the trigger language that initiates action, and from how and where you store your equipment to the steps of your FONA procedure. You need to weed out the inefficiency or unnecessary complexity until you’re left with only what will give you the ability to successfully perform FONA in under 3 minutes from the onset of refractory hypoxia.
Once you have begun to see your FONA approach through the lens of simplicity, it will become increasingly apparent. Here are some areas where the element of simplicity can be applied in your FONA practice. This is not an exhaustive list, but rather a starting point.
More On Design Thinking
If you are interested in UI design principles and how they translate to your FONA approach, check out this article here.
Elegant Simplicity Through History
Classical Example
This is not a new idea. Go back 500 years to the Renaissance and consider Leonardo da Vinci’s Mona Lisa. At first glance, it’s just a woman with a faint smile. But that subtle expression has captivated the world for centuries, not because it is simple, but because of the immense complexity that lies beneath it.
The composition of the painting, with its intricate layers of shadow and light, anatomical precision, mathematical proportions, and psychological depth, is astonishingly complex. Yet what emerges is something deceptively simple: a quiet, enigmatic smile that feels timeless.
Da Vinci didn’t stumble upon that simplicity. He crafted it through mastery—through the deliberate layering of technique, study, and experimentation. He arrived at simplicity only after going through complexity.
This is the same journey you must take to master FONA.
The goal isn’t to make it look hard. The goal is to accomplish something incredibly difficult and make it appear effortless.
Just like the Mona Lisa, the power lies in what’s beneath the surface.
The Bottom Line
There is a purpose to all of this. To help you stand calmly in the chaos of a CICO event. The way to achieve this is not by memorizing more information. It’s about designing better and iterating until your approach is so refined that it performs under stress.
Simplicity, on the far side of complexity, is the goal.
And design thinking is how you get there.
What’s Next
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