Emergency surgical cricothyroidotomy: 24 successful cases leading to a simple ‘scalpel–finger–tube’ method

Abstract

Surgical airway access justifiably remains the final option for managing the 'can't intubate can't ventilate' situation, but available techniques are often complicated and might require special equipment. This paper reports on the real world experience of two experienced Australian medical specialists with backgrounds in Anaesthesia and Aeromedical Retrieval who performed 24 surgical airways, mainly under adverse prehospital conditions, over a combined 40 years of practice. All attempts were successful, the majority through a simple open 'scalpel-finger-tube' method, which is described here.

Development of a standard operating procedure and checklist for rapid sequence induction in the critically ill

“…Presence of the surgical airway equipment on the RSI kit dump sheet, and familiarity with the equipment and technique involved is essential. The low success rate of cannula versus surgical cricothroidotomy should be considered in a CICV scenario on the ICU [5,55-58]. A simplified scalpel-finger-bougie technique for surgical cricothroidotomy has been shown to have high success rates even with inexperienced operators [55,56].…”

Every Surgical Resident Should Know How to Perform a Cricothyrotomy: An Inexpensive Cricothyrotomy Task Trainer for Teaching and Assessing Surgical Trainees

“…As such, opportunities to gain experience in performing this procedure are scarce. [7][8][9][10][11] This has created a demand for simulation-based training. As resident training time is capped and available funding for training becomes more limited, alternatives to traditional teaching models must be developed.…”

Management of pregnancy and obstetric complications in prehospital trauma care: faculty of prehospital care consensus guidelines

“…Thus, reducing the likelihood of iatrogenic injury or incorrect tube placement when establishing a surgical airway16 17 [II]. The increased soft-tissue oedema experienced in pregnancy, along with increased adiposity, can result in difficulty identifying key soft-tissue landmarks for the placement of the surgical airway.…”