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Room 01 // The cognitive tool
Keep the next decision available under pressure.
Airway knowledge is hardest to retrieve when the patient can least afford delay. Stress narrows attention, individual tasks consume the team, and a familiar intervention can become difficult to leave.
The Vortex compresses the airway emergency into a low-content visual tool that can be used while the event is unfolding. It is designed to keep the clinical state and the next decision visible without trying to carry the technical detail of each procedure.
The funnel gives that information physical form. Movement outward means alveolar oxygen delivery has been established. Movement inward means a best effort has failed and the team must use another lifeline.
Read the tool.Name the two directions the team can move and the clinical condition that determines each one.
Room 02 // Read the model
The device is not the destination.
Green Zone names the state in which alveolar oxygen delivery has been established and confirmed. The device matters because of what it achieves. Placement alone does not move the patient outward.
Restored oxygen delivery arrests the immediate descent toward hypoxaemia and creates relative safety. The team can reoxygenate the patient, gather resources, and develop its next strategy.
Lifeline means a route to oxygen delivery.
The Vortex recognizes three non-surgical upper-airway lifelines. The team may enter through whichever one fits the clinical situation and may use the remaining lifelines in the order the situation requires. The tool does not place them in a fixed hierarchy.
Name the state, then the route.Has alveolar oxygen delivery been established? Which lifeline is the team using to reach it?
Listen // The Green ZoneLegacy audio · Transcript pending
Listen // The three lifelinesLegacy audio · Transcript pending
Room 03 // Critical language
A repeated attempt is not automatically a better attempt.
Change the conditions
Optimization begins when the first attempt has not established adequate alveolar oxygen delivery. The team changes a condition that could make the lifeline work rather than simply repeating what just failed. The Vortex groups those changes into five categories that apply across all three lifelines; the device-specific actions belong in the Exhibits ahead.
Recognize the limit
Best Effort describes the point at which the viable strategies for entering the Green Zone through one lifeline have been used. It is context dependent and does not authorize unlimited attempts. If alveolar oxygen delivery remains unestablished after best effort, the term should trigger movement to another lifeline.
Separate optimization from repetition.What changed that could make the next attempt meaningfully different?
Room 04 // Critical language
CICO is a change in state—not a saturation threshold.
CICO exists when completed best efforts at all three upper-airway lifelines have failed to establish alveolar oxygen delivery. The problem has changed. Declare CICO and initiate Neck Rescue.
Do not wait for the oxygen saturation to reach a chosen number. A patient may still have oxygen reserve when the three lifelines are exhausted. Conversely, a critically low saturation does not itself establish CICO while a legitimate path to oxygenation through an upper-airway lifeline remains.
Transition begins before CICO. As each lifeline is exhausted, the team primes for Neck Rescue while the remaining lifelines are pursued. The goal is to be ready to act without delay if the third best effort fails.
Practice boundaryThis room teaches recognition, declaration, and transition—not emergency front-of-neck access technique. Teams require procedure training, equipment familiarity, and a locally approved plan.
Gallery complete // Practice remains
Put the model on the table.
Find the Green Zone, trace the three lifelines, and open the optimization plate beside each airway object.
Optional exhibitWatch the model become team behavior.+
Follow the model from explanation to action. Begin with the introduction, then watch the same cognitive structure organize a simulated airway emergency.
Accessibility note: These legacy explainers do not currently include complete caption and transcript records. They are retained under an approved legacy-media exception and remain scheduled for remediation.
Official Vortex Approach source →Practice Studio // Exhibit 02
Look at the model.
The 3D Vortex gives the mental construct a physical form. Find the Green Zone. Trace the three upper-airway lifelines around it. Then look at the device that represents each lifeline.
ObjectiveSee how the Green Zone and three lifelines fit together.
Finish lineFind the Green Zone. Name the lifelines. Open each plate.
Begin hereLook at the center of the model and find the Green Zone.
Objects to find
- 3D-printed Vortex
- BVM
- Supraglottic airway
- Endotracheal tube
- Printed optimization plates, if present
3D modelDigital optimization plates
Choose a lifeline around the model.
If its printed plate is not on the table, open the digital version here.
Vortex Approach · Lifelines and Best Effort ↗Each lifeline has its own device, skill set, and opportunities for optimization.
The detailed procedures belong in the lifeline Exhibits ahead.01 // Face-mask ventilation
Best Effort at FMV
Identify whether alveolar oxygen delivery is being impeded by the mask seal, airway patency, or both. Direct optimization toward the problem.
Open the official FMV matrix at source ↗
Open the face-mask ventilation Exhibit →
02 // Supraglottic airway
Best Effort at SGA
Identify where the device is being defeated: entry into the mouth, passage through the pharynx, or seating at the laryngeal inlet.
Open the official SGA matrix at source ↗
Open the supraglottic airway Exhibit →
03 // Endotracheal tube
Best Effort at ETT
Identify the step that is failing: obtaining the view, delivering the tube to the laryngeal inlet, or passing it into the trachea.
Open the official ETT matrix at source ↗
Open the endotracheal tube Exhibit →
The official matrices are training resources. The Vortex Approach does not present them as crisis-time implementation tools.
Before you leave
Point to the Green Zone, name the three upper-airway lifelines, and open the optimization plate for each.
This is an introduction to the model and its optimization vocabulary. The lifeline Exhibits teach the tools and procedures.Printed plate missing?
Use the digital plate beside the model. If the model or a device is missing, damaged, or contaminated, leave it in place and ask the station lead.
Installation Guide →
Place the 3D Vortex at the center with one representative BVM, supraglottic airway, and endotracheal tube around it. Printed optimization plates are optional because the three digital versions remain available in the Studio.
Exact equipment handling, cleaning, replacement, and local support routing remain owner-reserved.
Exit Passage
Take the model to the tools.
The Vortex keeps the team oriented while the airway changes: Is oxygen reaching the alveoli? Which lifeline is in use? Has it received a best effort? Does the state now require Neck Rescue?
The next Exhibit introduces the three upper-airway lifelines as routes to oxygen delivery. The Galleries and Practice Studios that follow open each lifeline into its tools, foundational procedures, and deliberate practice.
References & further exploration →
- Chrimes N. The Vortex: a universal ‘high-acuity implementation tool’ for emergency airway management. British Journal of Anaesthesia. 2016;117(S1):i20–i27.
- Chrimes N. Lifelines and Best Effort. The Vortex Approach.
- Chrimes N. Neck Rescue. The Vortex Approach.
