Groombridge Christopher, Maini Amit, Helsloot Dries, Luckhoff Carl, Fitzgerald Mark
School of Translational Medicine, Monash University, Melbourne, Australia.
Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia.
Scand J Trauma Resusc Emerg Med. 2025 Jun 12;33(1):104. doi: 10.1186/s13049-025-01413-3.
Emergency front of neck access (eFONA) may be life-saving in the can't intubate can't oxygenate scenario but the frequency with which an individual emergency department (ED) or emergency physician (EP) will be required to perform this intervention is very low.
Identify and describe all eFONA cases from the Alfred Airway Registry and to estimate the per clinician incidence of the procedure.
Retrospective case series of all eFONA cases from the Alfred Airway Registry. Data on all intubations undertaken in the ED were collected prospectively from February 2017 to January 2025. Data on individual clinician experience of eFONA was captured by an electronic survey.
Of the 1805 patients intubated during the 8 years study period, 4 cricothyroidotomies were performed (0.22%) with a scalpel-finger-bougie-tube technique. All were performed outside daytime hours (08:00-18:00) and all were successfully completed by clinicians who had previously practiced the procedure on a cadaver. 75% were in trauma patients, 75% were male and 75% were performed by emergency medicine doctors. From the survey data EPs performed 24 surgical airways in 768 years of consultant-level experience.
eFONA is a rare intervention occurring approximately once every 2 years in this trauma centre ED, and once every 32 years of consultant-level experience for the centre's EPs. The scalpel-finger-bougie-tube technique reliable achieved a secure airway in these patients.
在无法插管且无法给氧的情况下，紧急颈部前方入路（eFONA）可能挽救生命，但单个急诊科（ED）或急诊医师（EP）需要进行此干预的频率非常低。
识别并描述阿尔弗雷德气道登记处的所有eFONA病例，并估计该操作的每位临床医生发生率。
对阿尔弗雷德气道登记处的所有eFONA病例进行回顾性病例系列研究。2017年2月至2025年1月前瞻性收集了急诊科所有插管的数据。通过电子调查获取了关于临床医生个人eFONA经验的数据。
在8年的研究期间，1805例患者进行了插管，其中4例采用手术刀-手指-探条-气管导管技术进行了环甲膜切开术（0.22%）。所有操作均在白天时间（08:00 - 18:00）之外进行，并且均由之前在尸体上练习过该操作的临床医生成功完成。75%的患者为创伤患者，75%为男性，75%的操作由急诊医学医生进行。根据调查数据，急诊医师在768年的顾问级经验中进行了24次手术气道操作。
在该创伤中心急诊科，eFONA是一种罕见的干预措施，大约每2年发生一次，对于该中心的急诊医师而言，每32年的顾问级经验发生一次。手术刀-手指-探条-气管导管技术在这些患者中可靠地实现了安全气道。
