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Cricothyrotomy

A cricothyrotomy is performed by making a vertical incision on the skin of the neck just below the "Adam's apple", or thyroid cartilage, then another incision in the membrane which lies deep. A tube into this opening allows one to breathe for the patient with a machine or bag.

PubMed Health Glossary
(Source: Wikipedia)

What works? Research summarized

Evidence reviews

Emergency cricothyrotomy -- a systematic review

BACKGROUND: An emergency cricothyrotomy is the last-resort in most airway management protocols and is performed when it is not possible to intubate or ventilate a patient. This situation can rapidly prove fatal, making it important to identify the best method to establish a secure airway. We conducted a systematic review to identify whether there exists superiority between available commercial kits versus traditional surgical and needle techniques.

A meta-analysis of prehospital airway control techniques. Part II: Alternative airway devices and cricothyrotomy success rates

This review concluded that the King laryngeal tube airway device had the highest placement success rate in prehospital settings based on limited data. The authors recommended that surgical cricothyrotomy should be the preferred percutaneous rescue airway. This review had some methodological problems which together with the poor quality of the included studies suggest a cautious interpretation of the authors' conclusions.

Capnography for Monitoring End-Tidal CO2 in Hospital and Pre-hospital Settings: A Health Technology Assessment [Internet]

Anesthesiologists have been using capnography for decades to monitor end-tidal carbon dioxide (ETCO2) in patients receiving general anesthesia. ETCO2 monitoring using capnography devices has application across several hospital and pre-hospital settings, including monitoring the effectiveness of cardiopulmonary resuscitation (CPR), continuous monitoring of patients in the emergency room or intensive care unit (ICU), during ambulatory transport, to confirm the correct placement of an endotracheal tube (ETT), and monitoring post-operative patients with a history of sleep apnea or who have received high doses of opioids. Depending on the clinical area, the technology is at various stages of adoption.

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Terms to know

Cricoid Cartilage
A cartilage ring around the trachea below the thyroid cartilage.
Intubate
The insertion of a cannula or tube into a hollow body organ.
Larynx (Voice Box)
The area of the throat containing the vocal cords and used for breathing, swallowing, and talking. Also called voice box.
Thyroid Cartilage
The thyroid cartilage is the largest of the nine cartilages that make up the structure that contains the larynx. The cartilage is composed of two halves, which meet in the middle at a peak called the Adam's apple.
Trachea (Windpipe)
The airway that leads from the larynx (voice box) to the bronchi (large airways that lead to the lungs). Also called windpipe.
Tracheostomy (Tracheotomy)
Surgery to create an opening (stoma) into the windpipe. The opening itself may also be called a tracheostomy.
Tracheostomy Tube
A 2-inch- to 3-inch-long curved metal or plastic tube placed in a surgically created opening (tracheostomy) in the windpipe to keep it open. Also called trach tube.
Vocal Cords (Vocal Folds)
One of two small bands of muscle within the larynx that vibrates to produce the voice.

More about Cricothyrotomy

Photo of an adult

Also called: Crike, Thyrocricotomy, Cricothyroidotomy, Emergency airway puncture

See Also: Tracheostomy

Other terms to know: See all 8
Cricoid Cartilage, Intubate, Larynx (Voice Box)

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