Emergency percutaneous tracheostomy in a severely burned patient with upper airway obstruction and circulatory arrest

Schlossmacher, P.; Martinet, Olivier; Testud, Richard; Agésilas, F.; Benhamou, Léon; Gaüzère, B. A.

doi:10.1016/j.resuscitation.2005.06.021

Cited by 25 publications

(19 citation statements)

References 15 publications

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“…18 The occurrence of difficulties and/or failure to intubate the trachea successfully in these situations constitutes an important cause of complications, such as airway trauma, esophageal intubation, hypoxia, pulmonary aspiration, and adverse hemodynamic events. 8,9,19 In recent years, advances in optical technologies have facilitated the development of multiple novel indirect laryngoscopes. A common feature of these devices is that they visualize the glottis by indirect mechanisms, obviating the need to align the oral, pharyngeal, and tracheal axes and thereby potentially making laryngeal visualization and subsequent tracheal intubation easier to perform.…”

Section: Discussionmentioning

confidence: 99%

A comparison of the Glidescope®, Pentax AWS®, and Macintosh laryngoscopes when used by novice personnel: a manikin study

Malik

Hassett

Carney

et al. 2009

Can J Anesth/J Can Anesth

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Section: Discussionmentioning

confidence: 99%

A comparison of the Glidescope®, Pentax AWS®, and Macintosh laryngoscopes when used by novice personnel: a manikin study

Malik

Hassett

Carney

et al. 2009

Can J Anesth/J Can Anesth

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“…We previously observed that the Griggs method requires less time than Ciaglia technique [23]. Moreover, PCT performed using the Griggs technique may be used in selected cases to establish an emergency airway in patients with complete upper airway obstruction [35].…”

Section: No Patientsmentioning

confidence: 99%

Safety and complications of percutaneous tracheostomy in a cohort of 800 mixed ICU patients

et al. 2008

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Summary Percutaneous tracheostomy is used primarily to assist weaning from mechanical ventilation in the intensive care unit. We report our experiences of 800 such procedures performed in the intensive care unit by a collaborative team (critical care and ENT specialists). Most procedures (85.6%) were performed by residents supervised by the intensive care unit staff. Complications occurred in 32 patients (4%). Intraprocedural complications occurred in 17 patients (2.1%), early postprocedural complications in six (0.75%), and late postprocedural complications in nine (1.1%). No deaths were directly related to percutaneous tracheostomy. The incidence of complications was greater in percutaneous tracheostomy performed by the residents during their initial five attempts compared to their later attempts (9.2% vs 2.6%, p < 0.05). The low incidence of complications indicates that bedside percutaneous tracheostomy can be performed safely as a routine procedure in daily care of intensive care unit patients.

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“…On the contrary, if the patient cannot be intubated and also cannot be adequately oxygenated or ventilated with bag valve mask ventilation, the situation may be rapidly lethal [5][6][7]13,18,19,24) . As mentioned above, cricothyrotomy and tracheostomy are the methods of choice for patients in a critical condition and who have a difficult airway, and these procedures should therefore be performed swiftly and without any complication 1,21) . Tracheostomy can cause many complications 1,15) .…”

Section: Discussionmentioning

confidence: 99%

“…Tracheostomy can cause many complications 1,15) . We believe that methodical knowledge of neck region anatomy is the most important aspect of conventional cricothyrotomy and tracheostomy, and also for the application of new methods such as wire-guided cricothyrotomy and the Griggs technique for Tracheostomy 1,4,15,16,18,21) . Scurry and McGinn 22) reported that highriding truncus brachiocephalicus (innominate artery) causes fatal hemorrhage risk during inferior dissection.…”

Section: Discussionmentioning

confidence: 99%

“…Cricothyrotomy is performed in emergency situations in the prehospital period or in a hospital. Cricothyrotomy should be performed within three minutes to save a life and the consequences of a late cricothyrotomy may be disastrous for patients in critical condition 15,21) . We believe that methodical knowledge of the anatomy, the relationship between skin markers and palpation findings can be helpful in determining the exact location of the cricoid cartilage and cricothyroid ligament (Fig.…”

Section: Discussionmentioning

confidence: 99%

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Clinically Correlated Anatomical Basis of Cricothyrotomy and Tracheostomy

Gülşen

Ünal

Dinç

et al. 2010

J Korean Neurosurg Soc

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J Korean Neurosurg Soc 47 : 174-179, 2010Objective : Cricothyrotomy and tracheostomy are performed by physicians in various disciplines. It is important to know the comprehensive anatomy of the laryngotracheal region. Hemorrhage, esophageal injury, recurrent laryngeal nerve injury, pneumothorax, hemothorax, false passage of the tube and tracheal stenosis after decannulation are well known complications of the cricothyrotomy and tracheostomy. Cricothyrotomy and tracheostomy should be performed without complications and as quickly as possible with regards the patients' clinical condition. Methods : A total of 40 cadaver necks were dissected in this study. The trachea and larynx and the relationship between the trachea and larynx and the surrounding structures was investigated. The tracheal cartilages and annular ligaments were counted and the relationship between tracheal cartilages and the thyroid gland and vascular structures was investigated. We performed cricothyrotomy and tracheostomy in eleven cadavers while simulating intensive care unit conditions to determine the duration of those procedures. Results : There were 11 tracheal cartilages and 10 annular ligaments between the cricoid cartilage and sternal notch. The average length of trachea between the cricoid cartilage and the suprasternal notch was 6.9 to 8.2 cm. The cricothyroid muscle and cricothyroid ligament were observed and dissected and no vital anatomic structure detected. The average length and width of the cricothyroid ligament was 8 to 12 mm and 8 to 10 mm, respectively. There was a statistically significant difference between the surgical time required for cricothyrotomy and tracheostomy (p < 0.0001). Conclusion : Tracheostomy and cricothyrotomy have a low complication rate if the person performing the procedure has thorough knowledge of the neck anatomy. The choice of tracheostomy or cricothyrotomy to establish an airway depends on the patients' clinical condition, for instance; cricothyrotomy should be preferred in patients with cervicothoracal injury or dislocation who suffer from respiratory dysfunction. Furthermore; if a patient is under risk of hypoxia or anoxia due to a difficult airway, cricothyrotomy should be preferred rather than tracheostomy.

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Emergency percutaneous tracheostomy in a severely burned patient with upper airway obstruction and circulatory arrest

Cited by 25 publications

References 15 publications

A comparison of the Glidescope®, Pentax AWS®, and Macintosh laryngoscopes when used by novice personnel: a manikin study

A comparison of the Glidescope®, Pentax AWS®, and Macintosh laryngoscopes when used by novice personnel: a manikin study

Safety and complications of percutaneous tracheostomy in a cohort of 800 mixed ICU patients

Clinically Correlated Anatomical Basis of Cricothyrotomy and Tracheostomy

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