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[Acute upper-airway obstructions in primary care. Cricothyrotomy performed by the general practitioner]
J M Margot de Koning Gans1, Dorien L M Zwart, Cor J Kalkman
1Universitair Medisch Centrum Utrecht (UMCU), Kenniscentrum Patiëntveiligheid, Utrecht, The Netherlands.
Abstract:
Acute upper-airway obstructions, especially epiglottitis, are being observed with increasing frequency in adults, both in the hospital situation and in general practice. Acute upper-airway obstructions are life-threatening and therefore need to be treated with the highest priority. When interventions such as manual removal of a foreign body, thoracic compression or the Heimlich manoeuvre fail, the only remaining interventions are intubation and cricothyrotomy. However, only a few general practitioners (GPs) are skilled enough to perform these procedures. Should all GPs be trained in performing life-saving interventions such as cricothyrotomy? This is a difficult question; the intervention is invasive and has a high risk of complications, but securing the airway is a critical life-saving measure. Above all, there is very limited time available to wait for more experienced help. Therefore, we believe that GPs should be trained in performing life-saving interventions such as cricothyrotomy.
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