Cricothyroidotomy

Question 1

In what circumstances would a cricothyroidotomy be indicated?

Answer 1

Any situation in which attempts at orotracheal or nasotracheal intubation were unsuccessful, or carry an unacceptable level of risk. Examples include massive facial trauma, severe angioedema, burns, or a foreign body obstructing the airway.

Question 2

What are the potential complications of cricothyroidotomy?

Answer 2

subglottic stenosis
damage to the thyroid and cricoid cartilages

The 3 major complications are:
esophageal perforation
subcutaneous emphysema
excessive bleeding or hemorrhage

Question 3

A cricothyroidotomy should be converted to ____________ if airway access is needed for more than __ _____.

Answer 3

tracheostomy

72 hours

Question 4

What are the contraindications for cricothyroidotomy?

Answer 4

massive trauma to the larynx or cricoid cartilage

Question 5

A tracheostomy with an internal diameter of _ __ should be used.

Answer 5

6 mm

Question 6

What structures do you avoid by making a vertical incision instead of horizontal?

Answer 6

the recurrent laryngeal nerves

Question 7

What is the maximum depth your scalpel should penetrate into the trachea?

Answer 7

1.3 cm (1/2 inch)

Question 8

Once the trachea has been entered, make sure the blade stays ______ ___ ________ so that communication with the trachea is _____ ____.

Answer 8

within the incision

never lost

Question 9

The rate of failed emergency department intubations and subsequent surgical airway management is…

Answer 9

…lower than 0.6%.

Question 10

In the emergency department, cricothyroidotomy has been used for ___ to ___% of all intubation attempts in patients with ______.

Answer 10

1.0 to 2.8%

trauma