Evidence is important: Safety considerations for emergency catheter cricothyroidotomy

Abstract

It is an unarguable truth that providing appropriate training and equipment leads to improved outcomes in emergencies. Unfortunately, all too often the training and equipment are suboptimal and designed without sufficient attention to current evidence or an appreciation of the context of the emergency. Perhaps the starkest of these examples is in the provision of equipment and training for performance of the emergency surgical airway. A large, nationwide, year-long audit in the UK has shown that success rates for emergency cricothyroidotomy are highly variable ¹. Singled out for particular criticism has been the catheter or ‘needle’ method of accessing the airway and this is likely to be almost solely due to a lack of appropriate equipment and training. This commentary will outline the elements of safe practice of catheter cricothyroidotomy based on evidence from clinical and animal studies. The equipment, technique and potential complications will be reviewed.

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