Dr Nicholas Chrimes, FANZCA

Specialist Anaesthetist

Download the free e-book outlining the Vortex Approach. Available in a variety of formats to suit all computers, tablets, smartphones & e-readers.

Dr Peter Fritz, FACEM

Emergency Physician & Retrieval Specialist

Cognitive Tool

© Copyright Nicholas Chrimes & Peter Fritz, 2013. Vortex materials on this site may be used without alteration for clinical or educational purposes with acknowledgement of the authors & copyright holders. No derivative works.

The authors would like to recognise Monash Simulation in supporting the development of the “Vortex Approach”.

Download the Vortex Cognitive Tool for use in your clinical area.

“Why the ASA & DAS Algorithms Are Wrong!” William Rosenblatt MD interviews Nicholas Chrimes for Airway on Demand

Listen to Minh Le Cong’s Vortex interview with Nicholas Chrimes & Peter Fritz on PHARM

Hear Scott Weingart’s thoughts on the Vortex in this EMCrit Wee

Minh Le Cong interviews Martin Bromiley & Nicholas Chrimes about “Human Factors: Lessons from aviation & anaesthesia”


Overview The Vortex is a “high stakes cognitive aid” - simple enough to be recalled in a crisis and flexible enough to be used in any context. Our philosophy is to train staff for management of the unanticipated difficult airway in the same manner we train them to manage cardiac arrest - using a single simple & universally applicable template that is taught to all staff likely to be involved in managing the crisis - irrespective of critical care discipline and of whether they are from a medical, nursing or paramedical background.

Emergency Surgical Airway (ESA) Status

See how a modified version of Scott Weingart’s CriCon concept can be integrated into the Vortex approach in an attempt to improve the practical & psychological preparedness of clinicians to perform an emergency surgical airway.


Vortex Optimisation “Training Matrix”

Download this teaching tool to assist training your staff in the specific interventions available for airway optimisation under the 5 general headings for each non-surgical airway technique.

All educational materials may be reproduced with acknowledgement of the original authors. The authors have no financial interest in the Vortex Approach or related materials.

Journal Publication

Clinical use of the Vortex Approach is reported in a letter to the British Journal of Anaesthesia Br. J. Anaesth. (2014) 112 (4): 773-774

Nicholas Chrimes explains the Vortex in 90 secs


Vortex Airway Management Checklist

Designed to be used by any discipline, in any context requiring planned airway management, this tool provides a “pre-flight checklist” which prompts confirmation of key aspects of safe airway management prior to induction and specifically reinforces the Vortex Approach template during the preparation phase.

Ideally the Vortex Airway Checklist should be laminated “back to back” with the Vortex Cognitive Tool on the opposite side.

The aim is that by reinforcing the Vortex Approach format during routine preparation, this will facilitate its implementation when a difficult airway is encountered. It is also hoped that provision of a common checklist for use across different critical care specialities will facilitate development of a shared mental model for airway preparation and improve teamwork in situations when these groups come together.

The accompanying instruction page is intended as a reference resource only and is not for clinical use. Clinicians using the checklist  should have prior familiarity with the contents of the instruction page and be part of a team trained in advanced airway management.

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The live action segments of the “Vortex in Action” videos were produced by Monash Simulation and provided as open source intellectual property.

Neither Monash Simulation nor Monash Health are affiliated with

The Vortex Approach is recommended by the Australian & New Zealand College of Anaesthetists CPD Committee as an educational resource for the CICO Emergency Response Module.