Cricothyrotomy in difficult airway management: A narrative review

According to a recent Closed Claims Analysis, airway management problems arose during induction in 67% of cases, and involved difficult intubation in 6% of patients. The incidence of Cannot Intubate-Cannot Oxygenate (CICO) is low, occurring in 1 in 3200 cases in the operating room and in 1 in 500 case in the Emergency Department, according to some studies. Early establishment of a safe surgical airway is vital in a CICO patient.

Surgical cricothyrotomy is preferable to tracheotomy in patients requiring an emergency surgical airway. The cricothyroid membrane is located between the cricoid cartilage inferiorly and the thyroid cartilage superiorly. Cricothyrotomy is an emergency surgical airway approach in which the physician makes an incision in the cricothyroid membrane and passes a cannula or tracheal tube into the trachea in order to oxygenate and ventilate the patient. The procedure is relatively quick and simple, and involves minimal bleeding.

Emergency cricothyrotomy is the final step in all emergency airway management algorithms. Failure to recognise a CICO situation and immediately establish a surgical airway can rapidly lead to brain hypoxia and death.

The most common complications of cricothyrotomy include incorrect technique leading to injury of anatomical structures and oxygenation-ventilation failure, haemorrhage, and pneumothorax.

留言 (0)

沒有登入
gif