The Green Zone

airway management airwaylifeline airwayoptimisation safety vortex approach Feb 03, 2024

So, you’re in the green zone, now what? 🤔✅

The Vortex Approach describes the green zone as the zone of RELATIVE safety where your lifeline has succeeded and you can effectively provide oxygen. 🫁

Let's break it down:

1️⃣ First of all, how do you know you’re in the green zone?

👉 By observing the end-tidal CO2 is in a regular waveform (be aware that you will NOT see end-tidal CO2 with a cannula cricothyroidotomy!)
👉 The oxygen saturations are rising to a safe level.
👉 Observing for chest rise fall.
👉 The patient will be pink.

2️⃣ So, you’re in the green zone? Phew! Take a breath! Now is the time you stop and as a team discuss the next step. This stop is important in preventing you from rushing into a bad decision. Your next step will depend on the clinical situation, but your options are:

👉 Continue with the current airway
👉 Switch to a better airway
👉 Wake the patient up
👉 Arrange a surgical tracheostomy

That’s the green zone! You did it! Well done! 😄✅

Keep an eye out for our CICO Concept Series article and get your hands on a copy of our Anaesthetic Assistant Handbook for all this and more info, right in your scrub pocket!

Build knowledge ✅
Improve safety ✅


Note: all content licensed apart from images from which are distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License which permits use without alteration for non-commercial clinical or educational purposes with proper citation of the author & copyright holder of the original work. Authors include Dr Nicholas Chrimes and Dr Peter Fritz.

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