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What is Cricothyroidotomy?

In today's article, we will be discussing cricothyroidotomies. Continue reading to learn more!


 

Overview

Cricothyroidotomy, also known as cricothyrotomy, involves making an incision through the skin and cricothyroid membrane and placing a tube in. It is an essential emergency procedure performed to secure a clear airway. Intubation and ventilation typically fail due to factors such as difficult patient anatomy or excess blood in the patient’s mouth so as a result, cricothyroidotomy is performed. This procedure is done to prevent mortality or morbidity.



 

Indications

Before performing a cricothyrotomy, one must consider all the indications for a need to perform a cricothyrotomy.


These indications include:

  • Foreign body obstructing the airway

  • Swelling in the face, neck, or throat

  • Inability to ventilate or intubate

  • Large trauma to face or neck

  • Inability to perform a tracheostomy


 

Contraindication

Contraindication is a medical term used to describe a condition that serves as a reason to not do a certain procedure due to the harm it would cause the patient.


The contraindications for cricothyroidotomy include:


Situation 1

When there is a way to obtain an airway through a less invasive procedure.


Situation 2

If a child is under ten years of age. This is because children are susceptible to laryngeal

trauma and are at a higher risk for postoperative complications.



 

Complications

Some complications that can occur include:

  • Bleeding

  • Failure

  • Infection

  • Damage to local structures

  • Scarring

  • Hypoxia

  • Death

  • Cricoid fracture

  • Fistula formation


 

Standard Approach

Although there are many different techniques and approaches to

surgical cricothyroidotomy, there is a standard approach for this

procedure.


The following are the steps for the standard approach.

  1. First, make a midline incision over the cricoid membrane.

  2. Next, identify the cricothyroid membrane through blunt dissection.

  3. Make a short transverse incision in the lower part of the

  4. membrane.

  5. Stabilize the larynx with a tracheal hook.

  6. Then, dilate the ostomy with curved hemostats.

  7. Place Trousseau dilator in the incision and dilate the ostomy

  8. further.

  9. Finally, place the tube in the trachea.



 

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Just a disclaimer, photos used in this article may or may not depict cricothyroidotomy and photos used were meant to symbolize an aspect discussed in the article. All photos are not ours and belong to the respective owners.

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