Bougie-guided Cricothyrotomy Technique
1
Bougie-guided Cricothyrotomy Technique Cricothyrotomy is a life-saving surgical procedure that every emergency physician, anesthesiologist, and surgeon should be able to perform. This procedure is rarely needed due to improvements in other airway techniques and equipment, so most airway providers and surgeons are essentially novices when it comes to performing an emergent cricothyrotomy. Several different cricothyrotomy techniques have been described, and there is no standard method for performing this procedure. The ideal cricothyrotomy technique should be easy to learn and should utilize widely available airway equipment. Most cricothyrotomy techniques have not been studied, but the rapid four-step technique has been shown to be effective. While teaching the four-step cricothyrotomy technique in our procedure laboratory, and using it in clini- cal practice for the past several years, we noticed that the limiting step is usually insertion of the Shiley tracheal tube. Video Clip S1 (available as supporting information in the online version of this paper) shows a novel cricothyrotomy technique using an airway bougie and a standard endotra- cheal tube, instead of a Shiley tracheal tube. This technique is easy for novices to learn, utilizes standard equipment, and has been successfully used in clinical practice. Rob Reardon, MD ([email protected]) Scott Joing, MD Chandler Hill, MD Department of Emergency Medicine Hennepin County Medical Center Minneapolis, MN Supporting Information The following supporting information is available in the online version of this paper: Video Clip S1. Bougie-assisted cricothyrotomy technique. The video clip is in QuickTime. Please note: Wiley Periodicals Inc. is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing material) should be directed to the corresponding author for the article. Figure 1. Still image of cricothyrotomy. The bougie has been placed into the trachea through the cricothyroid membrane. The tracheal hook has been used to grasp the cricoid ring inferior to the cricoid membrane and it remains in place until the procedure is completed. ª 2010 by the Society for Academic Emergency Medicine ISSN 1069-6563 doi: 10.1111/j.1553-2712.2009.00638.x PII ISSN 1069-6563583 225 DYNAMIC EMERGENCY MEDICINE
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Transcript of Bougie-guided Cricothyrotomy Technique
Bougie-guided Cricothyrotomy Technique
Cricothyrotomy is a life-saving surgical procedure that everyemergency physician, anesthesiologist, and surgeon shouldbe able to perform. This procedure is rarely needed due toimprovements in other airway techniques and equipment, somost airway providers and surgeons are essentially noviceswhen it comes to performing an emergent cricothyrotomy.Several different cricothyrotomy techniques have beendescribed, and there is no standard method for performingthis procedure. The ideal cricothyrotomy technique shouldbe easy to learn and should utilize widely available airwayequipment. Most cricothyrotomy techniques have not beenstudied, but the rapid four-step technique has been shownto be effective. While teaching the four-step cricothyrotomytechnique in our procedure laboratory, and using it in clini-cal practice for the past several years, we noticed that thelimiting step is usually insertion of the Shiley tracheal tube.Video Clip S1 (available as supporting information in theonline version of this paper) shows a novel cricothyrotomytechnique using an airway bougie and a standard endotra-cheal tube, instead of a Shiley tracheal tube. This technique
is easy for novices to learn, utilizes standard equipment, andhas been successfully used in clinical practice.
Rob Reardon, MD
([email protected])Scott Joing, MD
Chandler Hill, MD
Department of Emergency MedicineHennepin County Medical Center
Minneapolis, MN
Supporting Information
The following supporting information is available in the onlineversion of this paper:
Video Clip S1. Bougie-assisted cricothyrotomy technique.The video clip is in QuickTime.Please note: Wiley Periodicals Inc. is not responsible for the
content or functionality of any supporting information suppliedby the authors. Any queries (other than missing material)should be directed to the corresponding author for the article.
Figure 1. Still image of cricothyrotomy. The bougie has been placed into the trachea through the cricothyroid membrane. Thetracheal hook has been used to grasp the cricoid ring inferior to the cricoid membrane and it remains in place until the procedureis completed.
ª 2010 by the Society for Academic Emergency Medicine ISSN 1069-6563doi: 10.1111/j.1553-2712.2009.00638.x PII ISSN 1069-6563583 225
DYNAMIC EMERGENCY MEDICINE
