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Emergency cricothyrotomy: a reassessment
M L Hawkins1, M B Shapiro, J I Cué
1Department of Surgery, Medical College of Georgia, Augusta 30912.
The American Surgeon
|January 1, 1995
Summary
Surgical cricothyrotomy is a safe and effective emergency airway procedure for trauma patients when nonsurgical methods fail. This technique demonstrated low complication rates and minimal long-term patient morbidity.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Airway Management
Background:
- Establishing an emergency airway is critical for trauma patients.
- Nonsurgical intubation may not always be feasible or successful.
- Cricothyrotomy offers a surgical alternative for rapid airway access.
Purpose of the Study:
- To evaluate the safety and efficacy of cricothyrotomy in adult trauma patients.
- To assess the complication rates and patient outcomes associated with cricothyrotomy.
- To determine the role of cricothyrotomy in emergency airway management.
Main Methods:
- Retrospective review of adult trauma patients admitted between January 1989 and June 1993.
- Analysis of patients requiring emergency airway control who could not be intubated nonsurgically.
- Documentation of cricothyrotomy procedures, complications, and subsequent airway management.
Main Results:
- Cricothyrotomy was performed in 66 of 525 patients requiring emergency airway control.
- Three major complications occurred in two patients, resolving without sequelae.
- Twenty-six patients survived with cricothyrotomy; 7 were decannulated, and 19 underwent tracheostomy.
- No clinically significant morbidity was attributed to cricothyrotomy.
Conclusions:
- Surgical cricothyrotomy is an important technique for selected trauma victims needing emergency airway control.
- The procedure is associated with a low rate of major complications.
- Cricothyrotomy can be performed with minimal morbidity, even when followed by tracheostomy.