Related Experiment Videos
Cricothyrotomy: a 5-year experience at one institution
Aaron E Bair1, Edward A Panacek, David H Wisner
1Division of Emergency Medicine, Department of Internal Medicine, University of California, Davis Medical Center, Sacramento, California 95817, USA.
The Journal of Emergency Medicine
|March 1, 2003
Summary
Emergency cricothyrotomy (cric) is performed in about 1% of ED airway cases, more often by air medical services. The rapid four-step technique (RFST) showed no complications in the ED, unlike other methods.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Air Medical Transport
Background:
- Emergency cricothyrotomy (cric) is a critical airway management technique.
- Understanding its prevalence, indications, and complications is vital for patient outcomes.
Purpose of the Study:
- To determine the prevalence, primary indications, and immediate complications of emergency cricothyrotomy.
- To compare complication rates between in-hospital (ED) and prehospital settings.
- To evaluate the safety and efficacy of the rapid four-step technique (RFST).
Main Methods:
- Retrospective review of patients undergoing cricothyrotomy between 1995 and 2000 at an academic trauma center.
- Inclusion of both Emergency Department (ED) and air-medical transport service (AMTS) procedures.
- Prospective definition of complication criteria by expert reviewers and blinded chart evaluation.
Main Results:
- Fifty cricothyrotomies were performed over five years, with 76% in trauma patients.
- Prevalence was 1.1% in the ED and 10.9% by AMTS.
- Complication rates were 14% in the ED versus 54.5% prehospital.
- The RFST, used in 77% of cases, had no reported complications in the ED.
Conclusions:
- Emergency cricothyrotomy is more prevalent in prehospital settings, primarily for trauma.
- The RFST demonstrates a significantly lower complication rate in the ED compared to non-RFST techniques.
- Prehospital cricothyrotomy is associated with a substantially higher complication rate than in-hospital procedures.