In emergency airway management, critical language refers to the use of standardized, high-clarity phrases that are immediately understood across disciplines and roles. These terms serve a vital function in time-sensitive, high-stakes scenarios where ambiguity can result in costly consequences, including loss of life. One of the most essential of these is “can’t intubate, can’t oxygenate” (CICO).

The CICO declaration is more than a clinical description—it is a call to action. It signals that conventional airway management has failed and that immediate transition to a front-of-neck airway (typically cricothyroidotomy) is now the priority. This language is deliberately unambiguous. It is designed to cut through the noise and cognitive overload that often accompany airway emergencies.

These two definitions are intertwined and crucial for 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.

The reason for this is clear: Time is brain. Poor communication leads to critical delays in FONA performance, and adverse outcomes related to failed airways are often caused by failure to oxygenate, rather than by failure to intubate. When the team declares CICO, a series of well-rehearsed actions should be performed to ensure FONA is completed before critical hypoxia occurs.