PMID: 9191664May 1, 1997Paper

Efficacy of prehospital surgical cricothyrotomy in trauma patients

The Journal of Trauma
J B FortuneS B Johnson

Abstract

The use of surgical cricothyrotomy (SC) in the prehospital setting is controversial, and the need to teach this procedure to paramedics and intermediate emergency medical technicians remains unclear. The purpose of this study is to define the efficacy, complication rate, and overall survival after SC performed in the prehospital setting. In our region, emergency medical technicians receive training in this technique using an animal model with bi-annual updates required. We retrospectively reviewed data in our regional trauma register (15,686 injured patients) for the years 1991-1995. Prehospital emergency airway intubation was required in 376 patients, 56 of whom received SC. The primary indications for SC were facial fractures and deformities (32%) and blood in the airway (30%). In 79% of the patients requiring SC, attempted orotracheal intubation prior to SC was unsuccessful, with a mean of 1.9 attempts per patient. SC was judged to provide an adequate airway in the field in 89% of attempts. Complications at the scene included six failed attempts, one case of excessive bleeding, and one adverse patient reaction (agitation). When patients arrived at the trauma center, the SC was judged to be acceptable in 64%, whereas 16% were...Continue Reading

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