Can't Intubate, Can't Oxygenate
Feb 08, 2024![](https://kajabi-storefronts-production.kajabi-cdn.com/kajabi-storefronts-production/file-uploads/blogs/2147545446/images/2e23-da84-31d-86d8-8c74d2cc8cd0_Concept_Series_website_YouTube_Banner_-2.png)
As easy as Ready, Set, Go… 1οΈβ£2οΈβ£3οΈβ£β
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! π€π€
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.
1οΈβ£ Cannula method kit contains
π 14g cannula
π 5mL syringe
π 2mL saline
π Rapid O2 device
2οΈβ£ Scalpel method kit contains
π Scalpel
π Bougie
π 6.0mm ETT
π 10mL syringe
The 4 stages to CICO escalation:
1οΈβ£ Priming - Easy as READY, SET, GO!
π Priming refers to preparation that occurs to limit the time between the last failed lifeline attempt and performing CICO rescue to limit hypoxic injury.
2οΈβ£ CICO Status Ready is when we lose our first lifeline and
π Help is called for
π Get the CICO kit out and ready to open
π Decide who will perform front of neck access
3οΈβ£CICO Status Set is when we lose the second lifeline and
π Kit is opened and equipment prepared
π Team ready to perform CICO rescue
4οΈβ£ CICO Status Go is when the third and final lifeline is lost and
π Patient’s neck is extended
π CICO rescue is performed
Remember, once CICO rescue is successful, you are now in the green zone. Phew! Well done. π₯³
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 π
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Ref: https://vortexapproach.org/neckrescueemergency