Background and Goal of Study: The “can't intubate, can't oxygenate” (CICO) situation is an increasingly rare event in anaesthesia practice. However, the importance of training for this situation has been highlighted in the National Audit Project 4 and Difficult Airway Society 2015 guidelines. We aimed to explore the perceptions of specialist anaesthetists at a Singaporean regional hospital regarding their readiness for managing a CICO situation.
Materials and Methods: All specialist anaesthetists at Changi General Hospital (CGH) were requested to complete an online survey regarding their experience, preferences and level of confidence pertaining to CICO situations. Surveys were sent to all 35 specialist anaesthetists working at CGH in April 2016. Twenty-nine responses were collected online and 5 responses manually.
Results and Discussion: Total response rate was 34/35 (97%). Experience of the respondents ranged from registrar to senior consultant level. Nine (26%) respondents had encountered a CICO situation previously. If faced with a CICO situation with a hypoxic patient, the preferred rescue technique was cannula cricothyroidotomy (11/34, 32%), followed by scalpel-bougie technique (10/34, 29%) and commercial cricothyroidotomy kit (9/34, 26%), with a further three (9%) preferring surgical tracheostomy by surgeon and one (3%) preferring a percutaneous tracheostomy.
Five (15%) were very confident they could quickly (< 2mins) fetch the equipment required to perform their preferred rescue technique in a CICO situation in the operating theatre and three (9%) were very confident they would be able to perform it. The number of respondents that were very confident in their abilities dwindled to two (6%) when asked if they would know how to use another technique if their preferred technique failed. 
Thirteen (39%) had either never attended an airway course that included CICO management or had done so more than five years ago. While there are no definitive revalidation requirements for CICO management, suggestions are that it should be recent, frequent and relevant.
Conclusion(s): Based on the results of the survey, establishing a dedicated and regular CICO workshop at CGH would be justified. Future studies should focus on whether standardising the equipment and techniques within the department and providing a CICO workshop will increase CICO readiness.

A survey of “can’t intubate, can’t oxygenate” (CICO) readiness amongst anaesthetists in a Singaporean regional hospital