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Cannot-intubate cannot-oxygenate airway — ABEM Board MCQ

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HardProcedures and resuscitationCannot-intubate cannot-oxygenate airwayABEM Board

A 45-year-old man arrives as ESI 1 after failed oral intubation for angioedema. He is cyanotic, cannot be ventilated with bag-mask, and supraglottic airway placement fails. SpO2 is 62%. Which of the following is the most appropriate initial action?

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Correct answer: A — Perform emergency cricothyrotomy

A cannot-intubate, cannot-oxygenate scenario requires immediate front-of-neck access.

Reference: ACEP Clinical Policy: Endotracheal Intubation; Difficult Airway Society emergency front-of-neck access guidance