A Comparison of Two Open Surgical Cricothyroidotomy Techniques by Military Medics Using a Cadaver Model

• Published in: Annals of emergency medicine Vol. 63; no. 1; pp. 1 - 5
• Main Authors: Mabry, Robert L., MD, Nichols, Matthew C., DO, Shiner, Drew C., MD, Bolleter, Scotty, BS, EMT-P, Frankfurt, Alan, MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.01.2014
• Subjects: Cadaver; Cricoid Cartilage - surgery; Cross-Over Studies; Emergency; Humans; Military Medicine - instrumentation; Military Medicine - methods; Time Factors; Tracheostomy - instrumentation; Tracheostomy - methods
• ISSN: 0196-0644; 1097-6760
• DOI: 10.1016/j.annemergmed.2013.08.025

Study objective The CricKey is a novel surgical cricothyroidotomy device combining the functions of a tracheal hook, stylet, dilator, and bougie incorporated with a Melker airway cannula. This study compares surgical cricothyroidotomy with standard open surgical versus CricKey technique. Methods This was a prospective crossover study using human cadaveric models. Participants included US Army combat medics credentialed at the emergency medical technician–basic level. After a brief anatomy review and demonstration, participants performed in random order standard open surgical cricothyroidotomy and CricKey surgical cricothyroidotomy. The primary outcome was first-pass success, and the secondary outcome measure was procedural time. Results First-attempt success was 100% (15/15) for CricKey surgical cricothyroidotomy and 66% (10/15) for open surgical cricothyroidotomy (odds ratio 16.0; 95% confidence interval 0.8 to 326). Surgical cricothyroidotomy insertion was faster for CricKey than open technique (34 versus 65 seconds; median time difference 28 seconds; 95% confidence interval 16 to 48 seconds). Conclusion Compared with the standard open surgical cricothyroidotomy technique, military medics demonstrated faster insertion with the CricKey. First-pass success was not significantly different between the techniques.