The emergent surgical airway: Cricothyrotomy vs tracheotomy

J. K. Dillon, B. Christensen, T. Fairbanks, Gregory Jurkovich, K. S. Moe

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

The American Society of Anesthesiologists difficult airway algorithm identifies two acceptable emergency surgical airways in the 'cannot intubate, cannot ventilate' scenario: cricothyrotomy and tracheotomy. Little has been published regarding the emergency surgical airway practices at different institutions. The authors investigated whether the primary choice of emergency surgical airway at a major level I trauma centre was cricothyrotomy or tracheotomy. A retrospective chart review was conducted of emergency airways performed over 6 years using relevant current procedural terminology codes. The electronic medical records obtained were reviewed to ensure accurate coding and verify the emergent nature of the procedure. Over the study period, there were 4312 documented emergent airways. 3197 (74.1%) were field intubated by paramedics, 1081 (25.1%) were hospital intubated by anaesthesia, 34 (0.008%) required emergency surgical access of which 24 were tracheotomies and 10 cricothyrotomies. Despite the emphasis in resident training and Advanced Trauma Life Support, there was a paucity of cricothyrotomies during the study period. At the authors' institution, tracheotomy is preferentially used as the emergency surgical airway. A multicentre prospective study is recommended to evaluate current practice in emergency surgical airway and to include the emergency open tracheotomy in residency training and continuing education if needed.

Original languageEnglish (US)
Pages (from-to)204-208
Number of pages5
JournalInternational Journal of Oral and Maxillofacial Surgery
Volume42
Issue number2
DOIs
StatePublished - Feb 1 2013
Externally publishedYes

Fingerprint

Tracheotomy
Emergencies
Advanced Trauma Life Support Care
Current Procedural Terminology
Allied Health Personnel
Electronic Health Records
Trauma Centers
Continuing Education
Internship and Residency
Multicenter Studies
Anesthesia
Prospective Studies

Keywords

  • cricothyrotomy
  • emergency surgical airway
  • tracheotomy

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology

Cite this

The emergent surgical airway : Cricothyrotomy vs tracheotomy. / Dillon, J. K.; Christensen, B.; Fairbanks, T.; Jurkovich, Gregory; Moe, K. S.

In: International Journal of Oral and Maxillofacial Surgery, Vol. 42, No. 2, 01.02.2013, p. 204-208.

Research output: Contribution to journalArticle

Dillon, J. K. ; Christensen, B. ; Fairbanks, T. ; Jurkovich, Gregory ; Moe, K. S. / The emergent surgical airway : Cricothyrotomy vs tracheotomy. In: International Journal of Oral and Maxillofacial Surgery. 2013 ; Vol. 42, No. 2. pp. 204-208.
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