Critical language during an airway emergency: Time to rethink terminology?

Abstract

Clear language should be used during emergency airway management to aid communication and understand the nature of the emergency. Unfortunately, during emergency airway management, there is no uniform language used for communication. Various difficult airway guidelines use different terminologies. Terminologies like "can't intubate, can't oxygenate" (CICO) and "can't intubate, can't ventilate" (CICV) have certain limitations. Though terminology like "Front of Neck Access" (FONA) is dominant in the literature,"emergency cricothyroidotomy" is used more often in clinical practice, suggesting a disconnect between the dominant terminology in the literature and in clinical practice. Terminology should not be used merely because it is catchy, simple and advocated by a few. It must accurately reflect the nature of the situation, convey a sense of urgency, and suggest an action sequence. An initiative to achieve consensus among existing terminologies is much needed. Leaders in the field should work towards refining airway terminology and replace poor phrases with ones that are more concise, precise and can be used universally in an airway emergency.

Keywords: Airway emergency; complete ventilation failure; critical language; emergency cricothyroidotomy.

Figure 1

Pathway to Hypoxia and Adverse Events Following a Failed Airway. Points 1, 2, 3 represent potential time points at which one may consider airway rescue