Emergency surgical cricothyroidotomy: 24 successful cases leading to a simple 'scalpel-finger-tube' method

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.