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;
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:
3 Inferior laryngotomy;
5 Coniotomy; or
6.Emergency airway puncture.