It is unclear when the first cricothyrotomy was performed and may originally date back to ancient Egypt.
However, the first modern procedure was performed in 1909 by Dr. Chevalier Jackson as a treatment fordiptheria.
This procedure quickly fell out of favor and didn’t return into the medical community until the 1970s.
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The cricothyrotomy is now the preferred method for establishing an emergent airway when other methods for oxygenation have failed.
What are the Important Acronyms to Understand?
CICOis an acronym representing “cannot intubate, cannot oxygenate”.
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ETtube is an acronym representing the endotracheal tube.
An endotracheal tube can be inserted through either the oral or nasal cavity.
This tube is inserted past the vocal cords into your trachea.
The ET tube is then connected to a gear that will deliver oxygen directly to your lungs.
FONAis an acronym representing “front of neck airway”.
FONA methods are only used when other forms that are less invasive have failed.
The cricothyroid membrane is a ligament that attaches the thyroid cartilage to the cricoid.
The thyroid cartilage is located above your thyroid and in front of your larynx that houses your voice box.
The top-middle part of the thyroid cartilage forms a “V” known as the laryngeal incisure.
This increased growth creates the Adam’s apple, which is also known as the laryngeal prominence.
The cricoid is cartilage that surrounds the whole trachea.
How to Locate the Cricothyroid Membrane
Locating the cricothyroid membrane takes some practice.
The laryngeal handshake method is one of the most popular methods to locate the cricothyroid membrane.
Prevalence of cricothyrotomy is not well understood.
It varies from facility to facility as well as provider to provider.
Does Having a Difficult Airway Increase My Risk of a Cricothyrotomy?
It is important that hospitals and emergency services have difficult airway carts available with a cricothyrotomy kit.
However, in children, there are some considerations that should be evaluated.
Children’s airways are smaller and more funnel-shaped than adults.
This causes a narrowing around the cricothyroid membrane.
The guidelines on children are not as clear as adults.
Age recommendations range from 5 to 12 years of age in performing a cricothyrotomy.
If cricothyrotomy is not an option for the child, a tracheostomy will be surgically placed instead.
This is performed below the level of the cricoid and towards the lower portion of the thyroid.
What is Included in a Difficult Airway Cart and Cricothyrotomy Kit?
How Is a Cricothyrotomy Performed?
A cricothyrotomy is not usually permanent.
2023;16:183-199. doi:10.2147/MDER.S419715
Emergency cricothyrotomy (cricothyroidotomy).
Uptodate.com (subscription required).
Cricothyrotomy and Percutaneous Translaryngeal Ventilation.
Roberts and Hedges Clinical Procedures in Emergency Medicine and Acute Care.
2018;121(5):1173-1178. doi:10.1016/j.bja.2018.07.034
McKenna P, Desai NM, Tariq A, Morley EJ.Cricothyrotomy.
In StatPearls [Internet].T reasure Island (FL): StatPearls Publishing; 2023
