- Definition: A technique for obtaining an emergency airway through the cricothyroid membrane when standard airway techniques have failed.
- Procedure: A large-bore intravenous cannula is inserted directly through the membrane.
- Surgical Cricothyroidotomy: A surgical hole is made in the membrane, and a cuffed tube, similar to a short endotracheal tube, is inserted directly.
Indications
- Need for an emergency airway where:
- Intubation is not possible
- Need to avoid neck manipulation
- Severe maxillofacial trauma
- Oedema of throat
- Severe oropharyngeal/tracheobronchial haemorrhage
- Foreign body in upper airway
- Lack of equipment for endotracheal intubation
- Technical failure of intubation
Complications
- Thyrohyoid membrane incision
- Intra/postoperative bleeding
- Subglottic stenosis
- Dysphonia/hoarseness
- Laryngeal damage
- Tube misplaced in bronchus
- Tracheal stenosis
- Recurrent laryngeal nerve injury
- Oesophageal perforation or tracheo-oesophageal fistula
- Tracheo-brachiocephalic vein fistula
- Fracture of thyroid cartilage