Having a Plan is not an isolated cognitive aid for you alone, its something that is easily communicated to your team and which clearly identifies a path based on recognized cues. The cue we believe is a simple dichotomy based on your ability to oxygenate the patient during attempts to secure an airway. If you CAN Oxygenate, you have time and can move to plan B. If you CAN'T Oxygenate you have no time. This is your exit strategy or plan C to rescue oxygenate. We lump ESA with SGA as cognitively this directs or rather gives permission to cut the neck while you try a supraglottic airway. This is cognitively different than trying an SGA then doing an emergency surgical airway, which may delay the decision and prolong a non-surgical route. Also your plan B may not be limited to a single second attempt at intubation. As long as you are able to oxygenate and there are realistic available options, up to 3 attempts may be appropriate.
Having a Plan is not an isolated cognitive aid for you alone, its something that is easily communicated to your team and which clearly identifies a path based on recognized cues. The cue we believe is a simple dichotomy based on your ability to oxygenate the patient during attempts to secure an airway. If you CAN Oxygenate, you have time and can move to plan B. If you CAN'T Oxygenate you have no time. This is your exit strategy or plan C to rescue oxygenate. We lump ESA with SGA as cognitively this directs or rather gives permission to cut the neck while you try a supraglottic airway. This is cognitively different than trying an SGA then doing an emergency surgical airway, which may delay the decision and prolong a non-surgical route. Also your plan B may not be limited to a single second attempt at intubation. As long as you are able to oxygenate and there are realistic available options, up to 3 attempts may be appropriate. 