‘Bougie-assisted’ cricothyroidotomy technique

Lowes, Tim

doi:10.1093/bja/aew293

Cited by 2 publications

(4 citation statements)

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“…The Difficult Airway Society (DAS) 2015 guidelines for management of unanticipated difficulties in intubation in adults advocated a didactic scalpel‐bougie cricothyroidotomy technique in order to promote standardised training for this rarely encountered crisis situation . However, this scalpel‐bougie technique has generated much discussion, as there is a concern that the scalpel may not provide an adequate pathway for the bougie and subsequently for the tracheal tube to follow , especially in obese patients with deep airway structures. This could lead to the formation of a false passage, trauma and failure .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a novel cricothyroidotomy introducer in a simulated obese porcine model: a randomised crossover comparison with scalpel cricothyroidotomy

et al. 2018

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The Difficult Airway Society 2015 guidelines for management of unanticipated difficulties in tracheal intubation in adults have generated much discussion regarding Plan D: emergency front-of-neck access with a scalpel-bougie cricothyroidotomy technique. There is concern that this technique may not provide an adequate pathway for the bougie and subsequently the tracheal tube, especially in obese patients with deeper airway structures. This could lead to the formation of a false passage, trauma and failure. A novel cricothyroidotomy introducer, 8 mm wide and 170 mm long, with a sharp leading edge and guiding channel to pass a bougie into the trachea, has been designed to complement the scalpel cricothyroidotomy technique. A comparison study of the use of this novel introducer with the scalpel technique in a simulated obese porcine laryngeal model demonstrated shorter insertion times (median (IQR [range]) 85 (65-123 [48-224]) s vs. 84 (72-184 [46-377]) s, p = 0.030). All 26 (100%) participants successfully performed cricothyroidotomy in the introducer group, whereas only 24 (92%) participants were successful in the scalpel group. The introducer group required fewer attempts to access the trachea compared with the scalpel group (p = 0.046). False passages occurred eight (31%) times in the introducer group compared with 17 (65%) times in the scalpel group (p = 0.022). There were no statistical differences in tracheal trauma (p = 0.490), ease of use (p = 0.220) and device preference (p = 0.240). This novel cricothyroidotomy introducer has shown promising results in securing the airway in an emergency front-of-neck access situation. With robust training, this introducer could potentially be complementary to the scalpel-bougie cricothyroidotomy technique.

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Section: Introductionmentioning

confidence: 99%

Evaluation of a novel cricothyroidotomy introducer in a simulated obese porcine model: a randomised crossover comparison with scalpel cricothyroidotomy

et al. 2018

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“…The model must also allow the user to confirm that tracheal, as opposed to esophageal, intubation has been established. The essential criteria outlined were deemed crucial to the simulation after researching the technique [ 15 ] and consulting with medical experts within the Department of Emergency Medicine at Memorial University, Newfoundland (MUN) (Dr. Michael Parsons, Dr. Adam Dubrowski, and Dr. Tia Renouf were the experts consulted) [A1]. A visual aid outlining the cricothyroidotomy can be found below (Figure 2 ).…”

Section: Technical Reportmentioning

confidence: 99%

“…The sagittal height and width were taken from dimensions L-M and L-L [ 14 ]. The thickness of the cricoid cartilage was determined by taking the average of both the mean value from men and women [ 15 ]. The overall tracheal length was taken from Table 5 [ 15 ].…”

Section: Figurementioning

confidence: 99%