What is Cricothyrotomy?

Cricothyrotomy is a last resort, lifesaving, procedure for paramedics who are treating a patient with a complete airway obstruction unable to managed in any other way.

To review normal paramedic advanced airway procedures please see my How to Intubate page.

A cricothyrotomy is an incision made through the skin and cricothyroid membrane to establish a patent airway during certain severe life-threatening airway obstructions.

The following are indications for cricothyrotomy:

1. Airway obstruction by a foreign body unable to be relieved through back blows, chest compression or the use of a laryngoscope and magills forcepts;

2. Angioedema;

3. Facial trauma;

4. Unable to intubate;

5. Unable to manually ventilate;

6 nasal injuries (that do not allow oral or nasal tracheal intubation)

7. Massive midfacial trauma

8 Possible cervical spine trauma preventing adequate ventilation

9. Anaphylaxis with angio oedema unresponsive to adrenaline;

10. Chemical inhalation /injuries

 

Cricothyrotomy is easier and quicker to perform than tracheotomy; howver, cricothyrotomy is not designed for longterm or definitive airway management, but lifesaving emergency treatments.

Paramedics never routinely perform cricothyrotomy – in fact, aneasthetists never routinely perform criocothyrotomy. Cricothyrotomy is for when things have gone wrong or were very wrong to begin with and is a very last resort.

Other names for cricothyrotomy include:

1.Thyrocricotomy;

2 Cricothyroidotomy;

3 Inferior laryngotomy;

4. Intercricothyrotomy;

5 Coniotomy; or

6.Emergency airway puncture.