Prophylactic cannula cricothyroidotomy and percutaneous oxygen insufflation with the Rapid-O2®: A simple and effective tool for enhancing safety in difficult airway management

• Published in: Anaesthesia and intensive care Vol. 51; no. 4; pp. 296 - 303
• Main Authors: Wexler, Sivan, Prineas, Stavros N
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.07.2023; Sage Publications Ltd
• Subjects: Airway management; Airway Management - methods; Anesthesia; Australia; Cannula; Humans; Insufflation; Intubation; Oxygen; Oxygen therapy; Tracheotomy; Australia; airway obstruction; complexity; Rapid-O2; cannula cricothyroidotomy; Head and neck; Vortex approach; non-technical skills; oxygen insufflation; difficult airway management; anaesthesia; percutaneous oxygenation
• ISSN: 0310-057X; 1448-0271
• DOI: 10.1177/0310057X221148212

Prophylactic cannula cricothyroidotomy is a recognised technique for actual or potential difficult airway management, where it confers a number of technical and non-technical benefits. Oxygenation with this technique is traditionally achieved by way of pressure-regulated, high flow jet ventilation and requires specialised equipment and considerable expertise for safe use, neither of which are always readily available. As an alternative, we describe the management of two patients with progressive upper airway obstruction in whom prophylactic cannula cricothyroidotomy and oxygen insufflation were performed using equipment which we consider is safer, widely available and already familiar to most anaesthetists throughout Australia.