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Outcomes after Prehospital Cricothyrotomy
Ratna M Malkan1, Cara M Borelli1, Romeo R Fairley1
1University of Texas Health San Antonio, San Antonio, TX.
Medical Journal (Fort Sam Houston, Tex.)
|January 6, 2023
Summary
Prehospital surgical cricothyrotomies are rare but associated with a high incidence of complications, particularly tracheostomy revision. Further research is needed to improve outcomes and training for this critical airway procedure.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Military Medicine
Background:
- Prehospital surgical cricothyrotomy is an under-evaluated procedure in both military and civilian settings.
- Complications associated with cricothyrotomy placement require further investigation.
Purpose of the Study:
- To identify the incidence and types of complications following prehospital combat surgical cricothyrotomies.
- To analyze outcomes of surgical cricothyrotomies in a combat casualty population.
Main Methods:
- Secondary analysis of the Department of Defense Trauma Registry (DODTR) dataset.
- Inclusion of casualties who underwent prehospital cricothyrotomy.
- Assessment for airway injuries and surgical procedures post-hospital admission.
Main Results:
- 251 casualties met inclusion criteria; median age 25, 98% male.
- Explosives (55%) and firearms (33%) were primary injury mechanisms.
- 14% of patients experienced complications, with 5% requiring tracheostomy revision.
Conclusions:
- Surgical cricothyrotomies are infrequently performed but carry a high complication rate in survivors reaching surgical facilities.
- Understanding outcomes is crucial for targeted training and technological advancements in airway management.
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