Front-of-neck access: a practical viewpoint, from experience

<span class="paragraphSection">Editor—The cogent editorial by Timmermann and colleagues<a href="#aex017-B1" class="reflinks">¹</a> deeply resonated with me. As an anaesthetic core trainee, I was called upon to obtain front-of-neck access in an emergency, using a scalpel and Mini-Trach kit (Portex, Smiths Medical, USA). The scenario was a cardiac arrest attributable to anaphylaxis and upper airway obstruction in the Emergency Department of a District General Hospital. Despite receiving excellent airway teaching and previous practice in simulation, I was psychologically unprepared for the practicalities. With no surgical training, it was unlike any task that I had previously performed, and I had no confidence in performing it proficiently. I was surprised by the bleeding, which inevitably occurred, and when the procedure proved to be difficult, I had no real-life experience with which to troubleshoot.</span>

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