Ultrasound Improves Cricothyrotomy Success in Cadavers with Poorly Defined Neck Anatomy: A Randomized Control Trial

Anesthesiology
Naveed SiddiquiKong Eric You-Ten

Abstract

Misidentification of the cricothyroid membrane in a "cannot intubate-cannot oxygenate" situation can lead to failures and serious complications. The authors hypothesized that preprocedure ultrasound-guided identification of the cricothyroid membrane would reduce complications associated with cricothyrotomy. A group of 47 trainees were randomized to digital palpation (n = 23) and ultrasound (n = 24) groups. Cricothyrotomy was performed on human cadavers by using the Portex device (Smiths Medical, USA). Anatomical landmarks of cadavers were graded as follows: grade 1-easy = visual landmarks; 2-moderate = requires light palpation of landmarks; 3-difficult = requires deep palpation of landmarks; and 4-impossible = landmarks not palpable. Primary outcome was the complication rate as measured by the severity of injuries. Secondary outcomes were correct device placement, failure to cannulate, and insertion time. Ultrasound guidance significantly decreased the incidence of injuries to the larynx and trachea (digital palpation: 17 of 23 = 74% vs. ultrasound: 6 of 24 = 25%; relative risk, 2.88; 95% CI, 1.39 to 5.94; P = 0.001) and increased the probability of correct insertion by 5.6 times (P = 0.043) in cadavers with difficult and impos...Continue Reading

References

Nov 1, 1991·Anaesthesia and Intensive Care·W M GriggsL I Worthley
May 1, 1990·Anesthesiology·R A CaplanF W Cheney
Mar 1, 1989·The Journal of Emergency Medicine·M J ErlandsonJ Cohen
Jul 1, 1982·Annals of Emergency Medicine·J McGillE Ruiz
Dec 22, 1999·Anesthesiology·K B DominoF W Cheney
Mar 1, 2003·The Journal of Emergency Medicine·Aaron E BairJohn C Sakles
Oct 18, 2008·The American Journal of Emergency Medicine·Scott E NichollsTania D Strout
Jul 22, 2010·Anaesthesia·D S J ElliottJ M D Thompson
Sep 3, 2010·Anesthesiology·Masayuki ShibasakiDaniel I Sessler
May 10, 2011·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·R EismaR W Soames
Nov 19, 2011·Acta Anaesthesiologica Scandinavica·M S Kristensen
Feb 1, 2013·Anesthesiology·Jeffrey L ApfelbaumUNKNOWN American Society of Anesthesiologists Task Force on Management of the Difficult Airway

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Citations

Aug 28, 2016·British Journal of Anaesthesia·P A BakerD Lockey
Mar 5, 2017·Journal of Anesthesia·Takashi Asai
Jan 19, 2017·Anesthesiology·Takashi Asai
Jan 31, 2017·Anesthesiology Clinics·Chiraag TalatiJose C A Carvalho
Dec 14, 2017·Journal of Clinical Monitoring and Computing·Bin WangXiaoju Jin
Jun 22, 2018·Acta Anaesthesiologica Scandinavica·H OhH G Ryu
May 8, 2019·Paediatric Anaesthesia·Bill WalshConan L McCaul
Oct 2, 2019·Clinical and Experimental Emergency Medicine·Seunghun ParkJun Seok Seo
Apr 11, 2019·Simulation in Healthcare : Journal of the Society for Simulation in Healthcare·Daniel Mandell, Steven L Orebaugh
Aug 23, 2019·Acta Anaesthesiologica Scandinavica·Vassilis AthanassoglouRichard Vanner
May 18, 2016·Anesthesiology·Paul J Zetlaoui, Dan Benhamou
May 18, 2016·Anesthesiology·James P Rathmell
Aug 17, 2016·Journal of Intensive Care·Adi Osman, Kok Meng Sum
Mar 17, 2017·F1000Research·Joelle Karlik, Michael Aziz
Aug 9, 2018·Critical Ultrasound Journal·Rein KetelaarsNico Hoogerwerf
Apr 16, 2016·Medicine·Kohji UzawaTomoko Yorozu
Jan 20, 2018·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Kong Eric You-TenMichael S Kristensen
Feb 6, 2018·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Daniel BainbridgeColin Royse
Feb 18, 2021·Critical Care Nursing Quarterly·Clayton M ClarkVictoria Goode
Mar 4, 2021·Irish Journal of Medical Science·Sunil K ChauhanConan L McCaul
Nov 3, 2020·British Journal of Anaesthesia·Michael S Kristensen, Wendy H Teoh
May 22, 2020·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Srikar AdhikariJohn Sakles
Apr 11, 2021·British Journal of Anaesthesia·Alistair F McNarry, Takashi Asai
Jul 30, 2021·BMJ Case Reports·Binu RavindranPrasad Vyakarnam
Aug 19, 2021·BMJ Case Reports·Anna Li, Jason D'Costa

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