A new indicator-guided percutaneous emergency cricothyrotomy device: in vivo study in man

There is presently no ideal method of securing an airway during acute upper airway obstruction. A new cricothyrotomy device has been developed, which has theoretical advantages. The goal of this clinical study in a head and neck cancer centre was to assess the safety of the device in man. Patients undergoing laryngectomy/laryngopharyngectomy for carcinoma were recruited. The outcome measures were as follows: time for completion, cardio-respiratory measurements and complications. Four experiments were performed. Two were performed by doctors trained in the technique and it proceeded smoothly, and ventilation was achieved in 110 and 84 s. Examination of excised larynges revealed minimal, but a short linear abrasion on the posterior wall. Two were performed by doctors who had received a limited explanation of the technique and it did not achieve a secure airway. With adequate prior training, this new cricothyrotomy procedure achieves a secure airway quickly with little trauma. This study supports the use of the new cricothyrotomy device by trained staff, but prospective audit of its application in real trauma settings is required.