This case involves a middle-aged male patient who presented to the hospital with a seizure. The patient developed an allergic reaction to the blood pressure medication he was given during his ED course and his airway began to swell uncontrollably. Intubation was indicated for airway protection from the swelling, but the anesthesiologist was unable to successfully intubate the patient after multiple attempts. In an attempt to save the patient’s life, an unsupervised general surgery resident performed an emergent cricothyrotomy and subsequently an open tracheotomy. The resident didn’t communicate to the attending about a difficult airway page from the emergency room. By the time the attending surgeon arrived, the patient’s clinical status had deteriorated significantly. The patient suffered from cardiac arrest and passed away. An expert in general surgery was sought to discuss the expected level of communication between the resident and attending surgeon in a case scenario like this.