Identifying the cricothyroid membrane: a comparison of palpation, laryngeal handshake and ultrasound

Comparison between ultrasound-guided and digital palpation techniques for identification of the cricothyroid membrane: a meta-analysis

“…A few published RCTs have shown the effectiveness of this ultrasound approach for improving the success rate of cricothyroid membrane identification compared with the conventional palpation technique. 2,3 However, most of these trials were small scale and conducted in different settings (e.g. emergency room or anaesthesia care unit), 4e8 and a number of studies failed to show significant differences in the accuracy of cricothyroid membrane identification between the two techniques.…”

“…emergency room or anaesthesia care unit), 4e8 and a number of studies failed to show significant differences in the accuracy of cricothyroid membrane identification between the two techniques. 1,3,4,8 Furthermore, there are concerns that the use of ultrasound technique may prolong the procedure time, 1,4,5,8 which can be life threatening in an emergency situation. We conducted this meta-analysis to analyse whether the ultrasound-guided approach is superior to the palpation technique in terms of procedural-related accuracy and procedure time.…”

“…Finally, eight studies published from 2014 to 2020 were considered relevant and were read in full. Of the eight studies, examiners assigned for cricothyroid membrane identification were anaesthetists and medical students in one study, 3 anaesthetists or anaesthesia trainees in six studies, 1,2,4e7 and postgraduate year trainees in the emergency department in one study. 8 In terms of the subjects whose cricothyroid membranes were to be localised, four studies enrolled patients or volunteers with normal neck anatomy, 2,3,7,8 three studies involved volunteers 5,6 or cadavers 1 with poorly identifiable neck landmarks, and one study recruited paediatric subjects.…”