NextGen learning designed to elevate your airway practice
Clear language is needed to cultivate a fearless FONA mindset, so that when someone says “CICO” everyone in the room knows what it means & what needs to happen next.
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.
These two definitions are important to developing a clear shared mental model in clinical environments where FONA may occur. They are interrelated and should be terms for which you have a great deal of clarity. Visit the Critical Language Compendium for more information on this and other important airway terminology.
When intubation fails, and adequate oxygenation cannot be delivered by any of the other upper airway lifelines (FMV&SAD) it’s time to declare CICO and move quickly to address the situation.
The reason for this is clear. Time is brain. Poor communication leads to critical delays in the performance of FONA, and bad outcomes related to failed airways are never caused by a failure to intubate, but rather a failure to oxygenate. When CICO is declared by the team a series of well rehearsed actions should occur that will lead to FONA being performed before critical hypoxia occurs.
When to Declare CICO
How many attempts before declaring CICO?
The answer is always BEFORE critical hypoxia occurs. This means you may have time to attempt restoration of adequate oxygenation with all of your three upper airway options, or you may be forced to bypass some or all of them if the situation mandates it. You can still use the time between declaring CICO and the actual incision to try to bridge with a supraglottic or FMV. Work in parallel not in series.
The most important thing to remember is that time is brain. Declare CICO early, and don’t get locked into feeling you have to attempt oxygenation with all your upper airway lifeline options, or that you have to attempt something 3 times. If your best effort(s) fail, or you judge the situation requires immediate transition to FONA then it’s time to moving on and perform rescue FONA.
Keep yourself on track and get credit for completion using this guide.
- Open the guide to a tab on your browser.
- Visit each poster & review the content.
- Complete any challenges to earn points.
Congratulations! You’ve completed this section of the learning space. Collect all the available points before moving on to the next poster to explore all the interactive and hands-on learning opportunities.
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.