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The OxygeNATION Cycle




Hard Sun – Eddie Vedder

start here

The Vortex Approach is your strategy, but what tactics will you use to oxygenate your patient? Listen here and then review this space.

The Online Learning Space

Enhanced Digital Content

Use this learning space in two ways. As an online course, scroll down and enter the online learning space. Explore each section below, or use the navigation tool to go directly to the content you’re interested in. Then, use this enhanced digital content in one of our pop-up physical spaces for hands-on procedure training, skills challenges, and expert coaching.


OptimizationBest Effort
Deeper DiveWhat’s Next


The first important concept

Not getting it right on the first try is not important, it’s what you do next that counts. You need a strategy for each upper airway lifeline (bvm, supraglottic, and endotracheal tube) so that you can rapidly cycle through them and optimize your performance.

Best Effort

acknowledging when this is as good as IT IS going to get

“The term ‘best effort’ is used by the Vortex Approach to describe the circumstance in which all viable strategies to facilitate success at entering the Green Zone via a given lifeline have been implemented. Up to three attempts (+/- a ‘gamechanger’ – see below), each incorporating additional optimisations that have not previously been implemented, are permitted to complete a best effort. The specific optimisations employed and the number of attempts that are appropriate to achieve a best effort are context dependent decisions, to be made by the airway operator within the confines of the principles set out by the Vortex Approach. 

If following a completed best effort at a particular lifeline, alveolar oxygen delivery has not been achieved, then no further attempts at that lifeline should occur. Efforts should instead focus on establishing alveolar oxygen delivery via an alternate lifeline – or on initiating Neck Rescue if all three lifelines have been unsuccessful.  

The Vortex Approach

Curated FOAMED resource

Tied to the successful deployment of your three essential upper airway lifelines. (1 – the bag valve mask 2 – the supraglottic airway 3 – the endotracheal tube) are the twin concepts of optimization and best effort. This video is a more detailed discussion of them as part of the vortex approach.

User Guide

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What’s Next


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If you can’t be with us in person, you can still use this enhanced digital content as an online course. Visit the digital home page of this learning space by using the link below. Otherwise, head to the next poster above to continue through the physical learning space.

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