The 4th National Audit Process of the Royal College of Anaesthetists (NAP4) ran for a 12 month period in 2011, collecting data from over 300 hospitals across the UK. The project examined major complications of airway management.

There were 80 emergency surgical airway attempts with an approximate incidence of FONA of 1:50 000 general anaesthetics:

• 37 surgical tracheostomies
• 34 needle cricothyroidotomies
• 6 surgical cricothyroidotomies
• 3 failures of all approaches

Importantly, the two major contributing causes of death were:

• Aspiration in 50% of cases
• CICO leading to hypoxia in 25% of cases