A marking of the cricothyroid membrane with extended neck returns to correct position after neck manipulation and repositioning.

Acta Anaesthesiologica Scandinavica
James BownessBarry McGuire

Abstract

Emergency front of neck airway access by anaesthetists carries a high failure rate and it is recommended to identify the cricothyroid membrane before induction of anaesthesia in patients with a predicted difficult airway. We have investigated whether a marking of the cricothyroid membrane done in the extended neck position remains correct after the patient's neck has been manipulated and subsequently repositioned. The subject was first placed in the extended head and neck position and had the cricothyroid membrane identified and marked with 3 methods, palpation, 'laryngeal handshake' and ultrasonography and the distance from the suprasternal notch to the cricothyroid membrane was measured. The subject then moved off the table and sat on a chair and subsequently returned to the extended neck position and examinations were repeated. Skin markings of all 11 subjects lay within the boundaries of the cricothyroid membrane when the subject was repositioned back to the extended neck position and the median difference between the two measurements of the distance from the suprasternal notch was 0 mm (range 0-2 mm). The cricothyroid membrane can be identified and marked with the subject in the extended neck position. Then the patient's p...Continue Reading

References

Dec 7, 2011·Anaesthesia·A E Hamaekers, J J Henderson
Nov 19, 2011·Acta Anaesthesiologica Scandinavica·M S Kristensen
Jan 30, 2014·The American Journal of Emergency Medicine·Michael MallinMatthew Ahern
Feb 1, 2015·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Austin LambIain Arseneau
Feb 20, 2015·British Journal of Anaesthesia·M S KristensenP A Baker
Jul 23, 2015·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Aaron E Bair, Rupinder Chima
Nov 12, 2015·British Journal of Anaesthesia·C FrerkUNKNOWN Difficult Airway Society intubation guidelines working group
Aug 23, 2019·Acta Anaesthesiologica Scandinavica·Vassilis AthanassoglouRichard Vanner

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Citations

Nov 3, 2020·British Journal of Anaesthesia·Michael S Kristensen, Wendy H Teoh

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