Can't Intubate, Can't Oxygenate
airway management airwaylifeline airwayoptimisation cico vortex approach Feb 08, 2024
As easy as Ready, Set, Go… 1️⃣2️⃣3️⃣✅
Can’t Intubate, Can’t Oxygenate or CICO (as the cool kids say), refers to the situation where a patient can’t be safely oxygenated after 3 optimal attempts at all 3 lifelines. This is the bottom of The Vortex and is where CICO rescue must be performed by gaining front of neck access to the trachea so we can oxygenate the patient! 😤😤
There are 2 ways of gaining front of neck access in a CICO rescue, these are the cannula and scalpel method and a kit for each should be kept in the CICO rescue drawer of The Vortex trolley.
1️⃣ Cannula method kit contains
👉 14g cannula
👉 5mL syringe
👉 2mL saline
👉 Rapid O2 device
2️⃣ Scalpel method kit contains
👉 Scalpel
👉 Bougie
👉 6.0mm ETT
👉 10mL syringe
The 4 stages to CICO escalation:
1️⃣ Priming - Easy as READY, SET, GO!
👉 Priming refers to preparation that occurs to limit the time between the last failed lifeline attempt and performing CICO rescue to limit hypoxic injury.
2️⃣ CICO Status Ready is when we lose our first lifeline and
👉 Help is called for
👉 Get the CICO kit out and ready to open
👉 Decide who will perform front of neck access
3️⃣CICO Status Set is when we lose the second lifeline and
👉 Kit is opened and equipment prepared
👉 Team ready to perform CICO rescue
4️⃣ CICO Status Go is when the third and final lifeline is lost and
👉 Patient’s neck is extended
👉 CICO rescue is performed
Remember, once CICO rescue is successful, you are now in the green zone. Phew! Well done. 🥳
Now check out our Concept Series on The Green Zone and our Advanced Anaesthesia Live Series recording on CICO! Instant and lifetime access for members 😄
Build knowledge ✅
Improve safety ✅
Ref: https://vortexapproach.org/neckrescueemergency
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