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Related Experiment Videos

Cricoid ring integrity: implications for cricothyrotomy.

Aaron E Bair1, Erik G Laurin, Ari Karchin

  • 1Division of Emergency Medicine, Department of Internal Medicine, University of California-Davis, 2315 Stockton Boulevard, PSSB #2100, Sacramento, CA 95817, USA. aebair@ucdavis.edu

Annals of Emergency Medicine
|February 28, 2003
PubMed
Summary
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The double-hook technique for cricothyrotomy requires slightly more force for intubation but significantly increases the cricoid ring

Area of Science:

  • Emergency Medicine
  • Surgical Techniques
  • Anatomy

Background:

  • The rapid 4-step cricothyrotomy technique traditionally uses a single hook on the cricoid ring.
  • Concerns exist regarding potential cricoid ring damage with single-hook placement.
  • A double-hook device was developed to distribute forces and potentially improve safety.

Purpose of the Study:

  • To compare the forces required for intubation using single- versus double-hook techniques.
  • To evaluate the structural tolerance of the cricoid ring under both techniques.
  • To assess the risk of cricoid ring damage during cricothyrotomy.

Main Methods:

  • 56 human cadaver specimens were randomized for cricothyrotomy and intubation.
  • Specimens underwent either single- or double-hook technique, with crossover for comparison.

Related Experiment Videos

  • Intubation and cricoid ring breakage forces were measured and analyzed with 95% confidence intervals.

    • Main Results:

    • Mean intubation force was 18 N (single-hook) vs. 23 N (double-hook).
    • Mean force to break the cricoid ring was significantly higher with the double-hook technique (101 N) compared to the single-hook technique (54 N).
    • The double-hook technique demonstrated a 47 N greater mean force tolerance before breakage.

    Conclusions:

    • Both single- and double-hook techniques require minimal force for intubation during cricothyrotomy.
    • The double-hook technique significantly enhances the cricoid ring's tolerance to force, reducing breakage risk.
    • This suggests the double-hook device may offer improved safety in emergency airway procedures.