Optimal practice for emergency ‘front-of-neck’ airway in trauma setting: Words of European Trauma Course Austria instructors

Purpose of the study: The essence of trauma airway management is to establish and/or maintain adequate oxygenation, ventilation, and airway protection. Unanticipated difficult airway (DA), accompanied with cervical immobility, represents a major challenge in trauma emergencies, and may result in significant morbidity and mortality. Therefore, all trauma personnel must be familiar with well-established framework for unanticipated DA management. Emergency ‘front-of-neck’ airway (FONA) represents ‘end-of-algorithm’ following ‘can’t intubate, can’t oxygenate’ (CICO) rescue scenario. For the purposes of these, the 2015 Difficult Airway Society (DAS) guidelines propose ‘scalpel-bougie’ (SB) technique. However, recent scientific evidence, depending on individual experience, training, and comfort of use, advocate other techniques, such as needle cricothyroidotomy (CCT). In our study we aimed to investigate European Trauma Course (ETC) instructors’ optimal practice for emergency FONA.