What should be done if a patient requires a secured airway but cannot be ventilated or oxygenated with a SaO2 greater than 90%?

The need for a secured airway in a patient who cannot be ventilated or oxygenated effectively, while still maintaining a saturation of oxygen (SaO2) greater than 90%, indicates a critical situation where standard airway management techniques have failed. In such cases, a more invasive procedure may be necessary to secure the airway and ensure adequate oxygenation and ventilation.

Initiating a cricothyroidotomy is indicated when other methods, like intubation, have not succeeded in establishing an effective airway. This emergency procedure creates a direct airway access through a small incision in the cricothyroid membrane, allowing for ventilation when traditional intubation is impossible due to anatomical or physiological challenges, such as severe airway obstruction or trauma.

When it comes to the other options, repeating attempts at laryngoscopy could lead to complications and delays in securing the airway while using nasal intubation may not be appropriate in cases of suspected head trauma or in situations where there is facial injury or obstruction. Administering more oxygen without securing the airway does not resolve the underlying issue of inadequate ventilation, which is critical in emergent scenarios.

A cricothyroidotomy provides a rapid and effective solution to restore airway patency and improve ventilation in patients who are unable to be ventil