SynthesisBritish journal of anaesthesia2023
Success rate of prehospital emergency front-of-neck access (FONA): a systematic review and meta-analysis.
Synthesis in British journal of anaesthesia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06645288 (The Use of an Emergency Reflex Action Drill in Emergency Surgical Airway), which is not on this map. Cited by 9 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Use of an Emergency Reflex Action Drill in Emergency Surgical Airway
Who cites it
9 citing papers in PubMed.
- Skill retention of advanced airway techniques after simulation training - a randomized prospective study.BMC medical education · 2026Trial
- Airway Decision-Making in Acute Epiglottitis: A Case Report of Planned Tracheostomy in a Can Ventilate but Cannot Intubate (CVCI) Scenario.Clinical case reports · 2026Article
- Training for pediatric cannot intubate cannot oxygenate: surgical airway should replace needle cricothyrotomy.Frontiers in disaster and emergency medicine · 2026Article
- From rare procedure to institutional capability: a proposal to embed systematic training and adoption of emergency front of neck access.British journal of anaesthesia · 2025Review
- Cricothyroidotomy in out-of-hospital cardiac arrest: An observational study.Resuscitation plus · 2024Article
- Emergency front-of-neck access in cardiac arrest: A scoping review.Resuscitation plus · 2024Article
- Pilot cadaveric study on the feasibility of cricothyroidotomy and the associated complications in 30 cats.Frontiers in veterinary science · 2024Article
- Anatomical morphometry for Cricothyrotomy puncture and incision.BMC surgery · 2023Article
- A challenging case of bradykinin-mediated angioedema with airway obstruction: management and therapeutic strategies.Archive of clinical cases · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFront-of-neck access (FONA) is an emergency procedure used as a last resort to achieve a patent airway in the prehospital environment. In this systematic review with meta-analysis, we aimed to evaluate the number and success rate of FONA procedures in the prehospital setting, including changes since 2017, when a surgical technique was outlined as the first-line prehospital method.
methodsA systematic literature search (PROSPERO CRD42022348975) was performed from inception of databases to July 2022 to identify studies in patients of any age undergoing prehospital FONA, followed by data extraction. Meta-analysis was used to derive pooled success rates. Methodological quality of included studies was interpreted using the Cochrane risk of bias tool, and rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
resultsFrom 909 studies, 69 studies were included (33 low quality; 36 very low quality) with 3292 prehospital FONA attempts described (1229 available for analysis). The crude median success rate increased from 99.2% before 2017 to 100.0% after 2017. Meta-analysis revealed a pooled overall FONA success rate of 88.0% (95% confidence interval [CI], 85.0-91.0%). Surgical techniques had the highest success rate at a median of 100.0% (pooled rate=92.0%; 95% CI, 88.0-95.0%) vs 50.0% for needle techniques (pooled rate=52.0%; 95% CI, 28.0-76.0%).
conclusionsDespite being a relatively rare procedure in the prehospital setting, the success rate for FONA is high. A surgical technique for FONA appears more successful than needle techniques, and supports existing UK prehospital guidelines. SYSTEMATIC REVIEW PROTOCOL: PROSPERO CRD42022348975.
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