Today, I review, link to one of the best teaching videos, Cricothyrotomy – Scalpel-Bougie-Tube technique from Hyperexis. 10:00. In addition, I review and link to additional resources:
- Scalpel-Finger-Bougie Cricothyrotomy Technique from Larry B. Mellick, MD. 2:26
- Cricothyrotomy – Classic surgical technique from Hyperexis. 7:49
And I excerpt from Ultrasound-guided Cricothyrotomy and a Novel 3-D Printed Training Model, Emergency Ultrasound Newsroom*, January 31, 2022:.
Cricothyrotomy by Ultrasound Guidance vs Palpation Alone
EM physicians are familiar with the technique of performing cricothyrotomy after identifying the CTM by palpation. In 2012, Keith Curtis and colleagues described a novel technique of ultrasound-guided, bougie assisted cricothyrotomy in cadavers.*7 In this study, operators viewed the laryngeal cartilaginous structures including the CTM with the linear ultrasound transducer in long axis, the CTM was cut with a scalpel under active ultrasound guidance, then the bougie and endotracheal tube (ETT) were passed. This study reported a success rate of 20/21 attempts and an average time to completion of 26.2 seconds. Others have described ultrasound guidance for percutaneous tracheostomy with the probe in a transverse orientation on the neck.8 Ultrasound has been shown to improve localization of the CTM, increase success rate and decrease complications of cricothyrotomy.2,3,9
*Curtis K, et al. Ultrasound-guided, Bougie-assisted cricothyroidotomy: A description of a novel technique in cadaveric models. Acad Emerg Med. 2012;19(7):876-9.