Related Experiment Video
Updated: May 3, 2026
Manufacture of a Multi-Purpose Low-Cost Animal Bench-Model for Teaching Tracheostomy
Published on: May 18, 2019
Cricothyroidotomy in out-of-hospital cardiac arrest: An observational study
Matthew Humar1,2, Benjamin Meadley1,2, Bart Cresswell1
1Ambulance Victoria, 375 Manningham Rd, Doncaster, Melbourne, Victoria 3108, Australia.
Insights
Cricothyroidotomy in out-of-hospital cardiac arrest (OHCA) showed low success rates and high mortality. Further research is needed to determine its role in cardiac arrest scenarios.
Area of Science:
- Emergency Medicine
- Surgical Procedures
- Cardiovascular Research
Background:
- Cricothyroidotomy is an airway management technique used in critical care.
- Its application and outcomes in out-of-hospital cardiac arrest (OHCA) require detailed investigation.
Purpose of the Study:
- To determine the incidence, characteristics, success rates, and outcomes of cricothyroidotomy in OHCA patients.
- To analyze factors associated with procedural success and complications.
Main Methods:
- Retrospective analysis of patient care records and cardiac arrest registry data over 18 years.
- Multivariable logistic regression to identify predictors of cricothyroidotomy success.
Main Results:
- 56 of 80 cricothyroidotomies were in OHCA patients, with an incidence of 1.1 per 1,000 resuscitations.
- Overall success rate was 68.8%, lower in OHCA (58.9%) vs. non-cardiac arrest (91.7%).
- Surgical techniques and male sex were associated with higher success; cardiac arrest and needle techniques with lower success.
Conclusions:
- Cricothyroidotomy in OHCA is associated with low procedural success and high mortality.
- Further studies are necessary to evaluate the specific role and benefits of cricothyroidotomy in cardiac arrest.
Aim:
To describe the incidence, characteristics, success rates, and outcomes of out-of-hospital cardiac arrest (OHCA) patients receiving cricothyroidotomy.
Methods:
Over an 18-year period, we retrospectively analysed patient care records and cardiac arrest registry data for cricothyroidotomy cases. Multivariable logistic regression analysis was used to examine associations between study characteristics and cricothyroidotomy success.
Results:
We identified 80 cricothyroidotomies, 56 of which occurred in OHCA. The incidence of cricothyroidotomy in OHCA was 1.1 per 1,000 attempted resuscitations and increased over the study period (incidence rate ratio [IRR] = 1.13, 95 % confidence interval [CI]: 1.02-1.25, p = 0.023). The overall success rate was 68.8 % (n = 55/80), with lower success in cardiac arrest (n = 33/56, 58.9 %) than non-cardiac arrest patients (n = 22/24, 91.7 %). In OHCA, success rates were higher for surgical compared to needle techniques (88.2 % vs. 54.6 %, p = 0.003). Cardiac arrest (odds ratio [OR] 0.09, 95 % CI 0.16-0.51) and needle techniques (OR 0.11, 95 % CI 0.02-0.56) were independently associated with lower odds of procedural success, while male sex (OR 10.06, 95 % CI 2.00-50.62) was associated with higher odds. Return of spontaneous circulation occurred in 44.6 % (n = 22/56), with 35.7 % (n = 20/56) surviving to hospital and 7.1 % (n = 4/56) surviving to hospital discharge. Procedural complications included cardiac arrest (n = 6/56, 10.7 %), minor bleeding (n = 5/56, 8.9 %), surgical emphysema (n = 3/56, 5.4 %), and major bleeding (n = 2/56, 3.6 %).
Conclusion:
We found cricothyroidotomy in OHCA to be associated with low rates of procedural success and high mortality rates. Further studies are required to assess the role and potential benefits of cricothyroidotomy in cardiac arrest.
Related Concept Videos
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques