An orderly plan of action for correcting the occasional critical airway obstruction is essential; otherwise irreversible brain damage and even death may occur before effective action is taken. A safe, simple, and effective plan has been developed for restoring ventilation in critical airway emergencies. The four basic steps are: recognition of obstruction; nonsurgical maneuvers to relieve obstruction; mouth-to-mouth breathing to overcome obstruction or to diagnose persistent obstruction; and establishment of emergency surgical airway. Cricothyroid membrane puncture is the safest and simplest method for establishing a satisfactory airway under adverse and serious conditions.
Theodore H. Nicholas, George F. Rumer. Emergency Airway—A Plan of ActionThe Four Basic Steps for Restoring Ventilation in Critical Airway Emergencies Are Cited in This Orderly Plan of Action. JAMA. 1960;174(15):1930–1935. doi:10.1001/jama.1960.03030150018005