Accuracy of identifying the cricothyroid membrane by anesthesia trainees and staff in a Canadian institution

Comparing success rates of anesthesia providers versus trauma surgeons in their use of palpation to identify the cricothyroid membrane in female subjects: a prospective observational study

“…7,[13][14][15][16] Results of the "Fourth National Audit Project" revealed that anesthesiologists failed to perform a successful percutaneous emergency surgical airway 64% of the time when attempted in the cannot intubate, cannot oxygenate setting. 7 Conversely, this audit revealed that all three open cricothyrotomies and 29 tracheostomies were performed successfully (presumably by surgeons) as first choice options for emergency surgical airways.…”

“…7 The first step in the performance of an emergency cricothyrotomy is accurate identification of the CTM, which is often not an easy task in both non-emergency and emergency situations. 5,13,[15][16][17] Predictors of difficult cricothyrotomy include difficulty identifying the location of the CTM (Fig. 1) and difficulty accessing the trachea through the anterior neck.…”

Obstructing pathology of the upper airway in a post-NAP4 world: time to wake up to its optimal management

“…19 If an emergency cricothyrotomy is a backup plan, the location of the cricothyroid membrane (CTM) should be determined and marked beforehand, recognizing that existing studies indicate poor success at identification of the CTM by palpation alone. [20][21][22] Thus, if time permits, ultrasound should be used to locate the CTM. 23 The surgical safety briefing should include the planned primary and alternative intubation techniques as well as the plan for a CICO situation.…”

“…19 Si une cricothyrotomie d'urgence est le plan de secours, la position de la membrane cricothyroïdienne (MCT) doit être déterminée et marquée sur la peau au préalable, les études existantes indiquant le faible taux de réussite de la localisation de la MCT par palpation seulement. [20][21][22] Ainsi, si le temps le permet, une échographie doit être réalisée pour localiser la MCT. 23 Deux raisons peuvent justifier de renoncer à la sédation d'un patient éveillé présentant des voies aériennes fragilisées.…”

Use of a nerve stimulator to assist cricothyroid membrane puncture during difficult airway topicalization

“…1 The Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society also reported a failure rate of 40-65% for needle cricothyroidotomy in emergency situations. 2 Since this procedure is rarely performed, most emergency personnel have either limited or no experience with needle cricothyroidotomy.…”