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.
In response to a great Twitter discussion with PHARM‘s @ketaminh:
See Minh le Cong’s PHARM blog post, video and podcast here. Please note that using a BVM is not the advised technique of oxygenation, but is used here because we don’t have an oxygen source in the skills lab.
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: