This video demonstrates how this might look in real-time during an airway crisis. The staff already know one another so names/roles aren't declared. Note slightly different Vortex terminology in this era (optimal attempt = best effort, ESA status = Priming Status)

When help arrives at an airway emergency the responsibility to communicate key information is shared by both the operator & arriving help - but the help may be better cognitively placed to ensure this occurs. Actively seek the following info when attending an airway crisis.

A 'best effort' at any upper airway lifeline (FM, SGA, TT) should incl an attempt with full NM blockade Intubation wout NMB ⬆️ trauma & ⬇️ success NMB ⬆️ success w FM & SGA NMB also provides optimal conditions for neck rescue vortexapproach.org/lifelines… sciencedirect.com/science/ar…

"Sniffing position" = BOTH base of neck flexion & AO extension (=> #Flextension per @doctimcook) Torso elevation helps ⬆️ FRC, ease of PPV & may be necessary to achieve flextension if high BMI. Ramping = flextension + torso elev vortexapproach.org/lifelines… sciencedirect.com/science/ar…

A 'best effort' at facemask ventilation should always include a 2-handed attempt using "vice grip". vortexapproach.org/lifelines… sciencedirect.com/science/ar…

'Priming' refers to escalations in readiness to perform neck rescue undertaken BEFORE a neck rescue emergency arises, to minimise delays to restoring O2 delivery. Priming status tool provides a structured approach to this. sciencedirect.com/science/ar… VortexApproach.org/cico#cico…

The Vortex airway rescue cart integrates presentation of equip w the Vortex so that it becomes an extension of the cognitive aid, prompting performance. More info on HF based airway carts in @Anaes_Journal: associationofanaesthetists-p… Create your own free: VortexApproach.org/airwaycar…

Turning a plan into a strategy requires repeatedly asking "What is the plan if that plan fails?" Each component plan in the strategy should address optimising lifelines, degree of priming for neck rescue & appropriate actions if the Green Zone is entered vortexapproach.org/planning

Inability to intubate is an inconvenience. Inability to ventilate is a crisis. Repeated airway instrumentation can convert a "can ventilate" situ into a "can't ventilate" situ. When ventilation is possible, use the opportunities of the Green Zone before reinstrumenting the aw.

Find the answer at VortexApproach.org

The key question that separates an airway 'plan' from an airway 'strategy': "What is the plan if that plan fails?" Keep asking yourself that question until the answer is "I would perform neck rescue". Then you have a strategy.

Also thanks to Phil Cohen & the GP Anaesthetists of the ‘Rural Anaesthesia Down Under Facebook Group’ for designing & providing the Vortex 3D model.

An additional attempt may be allowed in rare circumstances where it introduces “gamechanger”optimisations, considered to have a profound impact on the likelihood of success at the relevant lifeline, that were unable to be introduced within the 3 attempt limit.

The Vortex Airway Rescue Cart: 3 key features. 1. Dedicated airway rescue cart 2. Icons & layout integrated with Vortex cognitive tool 3. Visual cues for non-equipment interventions during airway rescue

The ARA simulation unit (ARASIM) in Rosario, Argentina is training the city's anesthesiologists in human factors aspects of managing anaesthetic crises using the @VortexApproach, incl distributing Vortex airway trolleys to public hospitals in the region. ararosario.com.ar

Vortex Approach airway rescue carts & education being rolled out at 70 public hospitals as part of major airway safety initiative in Buenos Aires

Places selling fast for the @VortexApproach workshop with @NicholasChrimes & @DrGivasHit at @WAMM_2019. Don’t miss out. Book now at confpartners.eventsair.com/w… Register for conference at wamm2019.com