[Emergency cricothyrotomy—puncture or anatomical preparation? Peculiarities of two methods for emergency airway access demonstrated in a cadaver model]

T S Mutzbauer, R Munz, M Helm, L A Lampl, M Herrmann
Der Anaesthesist 2003, 52 (4): 304-10

OBJECTIVES: The aim of the study was a demonstration of peculiarities of two invasive airway management methods performed by anesthesiology residents as a subgroup of emergency physicians.

METHODS: During an airway management training seminar,2 groups including 18 anaesthesiology residents and 2 students performed a simulated emergency surgical cricothyrotomy on unfixed cadavers. The more experienced physicians in group 2 started with a puncture technique preceding a blind surgical approach. The time needed to perform each procedure and resulting complications were analyzed.

RESULTS: The time taken ranged from 75 to 280 s (median 180 s) in group 1 and from 53 to 255 s (median 73 s) in group 2. The surgical approach caused "bleeding" in 40% (group 1) and 30% (group 2) and damage to the cartilages occurred in 20% and 30%, respectively. Punctures were performed within 10-36 s (median 25 s) and 70% were successful without complications.

CONCLUSIONS: Puncture of the cricothyroid membrane can serve as initial emergency approach or as intermediate airway access until a surgical method is available.

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