The Vortex is based on the principle that there are three ‘nonsurgical’ techniques to establish a patent airway: use of a face mask, a supraglottic airway, or an endotracheal tube. If a best effort at each of these three upper airway ‘lifelines’ is unsuccessful, then airway patency must be restored by initiating ‘CICO rescue’ (emergency front-of-neck access). Rather than the traditional algorithm-based design, the Vortex uses a simple graphic that depicts the upper airway lifelines as three zones arranged in a circular fashion around a central area representing CICO rescue. If a ‘best effort’ at any of the three lifelines is unsuccessful, this mandates spiral movement inward to the next lifeline. The
circular arrangement of the three lifelines means that airway management can commence with any lifeline and proceed between the remaining ones in any sequence according to what is judged most appropriate in a given context. This more accurately depicts real-world practice than the rigid sequence mandated by an algorithm. Inability to establish alveolar oxygen delivery after best efforts at all three lifelines culminates in arrival at the central
zone, representing the need to initiate CICO rescue.
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