{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T18:02:35Z","timestamp":1785348155398,"version":"3.55.0"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Anaesth Intensive Care"],"abstract":"<jats:p>We describe an out-of-theatre hypoxic cardiac arrest precipitated by spontaneous carotid blowout syndrome, resulting in massive haemorrhage with airway contamination and a \u2018can\u2019t intubate, can\u2019t oxygenate\u2019 crisis. Emergency front-of-neck access (eFONA) using a scalpel\u2013bougie technique unintentionally traversed the thyrohyoid membrane; however, this fortuitously enabled effective oxygenation and return of spontaneous circulation. Ongoing oropharyngeal haemorrhage was stabilised with packing and haemostatic resuscitation prior to definitive endovascular repair of an internal carotid pseudoaneurysm. This case demonstrates that an unintended thyrohyoidotomy, although not recommended, may function as a viable eFONA route in extremis, and highlights that temporary packing should be considered as part of a multidisciplinary approach to the management of major airway bleeding.<\/jats:p>","DOI":"10.1177\/0310057x261462196","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T04:33:03Z","timestamp":1785126783000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Carotid blowout with \u2018can\u2019t intubate, can\u2019t oxygenate\u2019 crisis: Supraglottic surgical airway rescue"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7668-6537","authenticated-orcid":false,"given":"William T.","family":"Birkett","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Perioperative Medicine, Monash Health, Melbourne, Australia"},{"name":"Department of Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3720-914X","authenticated-orcid":false,"given":"Walston R.","family":"Martis","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Perioperative Medicine, Monash Health, Melbourne, Australia"},{"name":"Department of Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia"},{"name":"Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia"},{"name":"Department of Critical Care, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"O\u2019Halloran","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Perioperative Medicine, Monash Health, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/ANA.0000000000001060"},{"key":"e_1_3_2_3_2","unstructured":"Australian and New Zealand College of Anaesthetists (ANZCA). PG61: Guideline for the management of evolving airway obstruction: Transition to the Can\u2019t Intubate Can\u2019t Oxygenate airway emergency. Melbourne Australia: ANZCA https:\/\/www.anzca.edu.au\/safety-and-advocacy\/standards-of-practice\/professional-documents (2017 accessed 6 November 2025)."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2025.10.006"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004002"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer058"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14998"},{"key":"e_1_3_2_8_2","unstructured":"Australian and New Zealand Tripartite Anaesthetic Data Committee. webAIRS www.anztadc.net (2023 accessed 25 February 2026)."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14706"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e32835528b1"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000001100"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aew175"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2009.05888.x"},{"key":"e_1_3_2_14_2","unstructured":"Chrimes N Fritz P. Neck rescue kits. The Vortex approach www.vortexapproach.org\/cicokits (accessed 6 November 2025)."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/ams2.937"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.10.004"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.08.012"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2024.111024"}],"container-title":["Anaesthesia and Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X261462196","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0310057X261462196","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X261462196","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T17:56:23Z","timestamp":1785347783000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0310057X261462196"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,26]]},"references-count":17,"alternative-id":["10.1177\/0310057X261462196"],"URL":"https:\/\/doi.org\/10.1177\/0310057x261462196","relation":{},"ISSN":["0310-057X","1448-0271"],"issn-type":[{"value":"0310-057X","type":"print"},{"value":"1448-0271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,26]]},"article-number":"0310057X261462196"}}