Quick overview of the surgical cricothyroidotomy technique as presented in the 2015 Difficult Airway Society guidelines. This is simply presenting the technique in a manikin model, not intended as a debate about the relative merits of needle vs. surgical, blade vs. hook, scalpel-finger-bougie vs. scalpel-bougie-tube, etc!
Don’t forget to wear your PPE (gloves, mask, eye protection) and appropriately secure the tube afterwards.
As always, constructive criticism and suggestions for improvement are always welcomed in the comments section.
Lots of ensuing discussion of the ideal angle of puncture of the cricothyroid membrane. 90 degrees (perpendicular to skin) has least risk of puncturing posterior wall of the trachea, but greatest risk of cannula kinking. I advocate around 60 degrees for puncture and then decreasing angle to advance cannula:
This month’s edition of Anesthesiology News features a worthwhile piece from Prof John Doyle, in which he poses 7 questions on the current state of airway management to 6 airway experts from around the world (Abdelmalak, Cooper, Frova, Rosenblatt, Spiegel and Doyle himself), and collates their responses into a dialogue. Definitely worth reading to determine what some (certainly not all) of the biggest names in the world are thinking on:
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