Melker cricothyrotomy kit: an alternative to the surgical technique

Emergent cricothyrotomy is a potentially lifesaving procedure central to acute airway algorithms. In most cases in which cricothyrotomy is indicated, the acuteness of the airway precludes subspecialty consultation before performance of the procedure. The academic environment is an exception, in which the responsibility of securing a "difficult" cricothyroid airway may fall upon junior otolaryngology residents. Described here is the use of the Melker Emergency Cricothyrotomy Kit, a prepackaged kit that uses a wire-guided percutaneous dilational technique (the Seldinger technique) and a procedure-specific polyvinylchloride airway catheter. The wire-guided technique may add a margin of safety for a relatively inexperienced resident performing cricothyrotomy. Furthermore, a newly released version of the kit includes instrumentation for insertion of the Melker airway catheter by the classic surgical technique in addition to that required for the Seldinger technique, which may enable even a seasoned surgeon to secure the airway faster and more safely.