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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

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05.05.2016 | Editorials

Deficiencies in locating the cricothyroid membrane by palpation: We can’t and the surgeons can’t, so what now for the emergency surgical airway?

verfasst von: J. Adam Law, MD

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 7/2016

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Excerpt

At times, it seems that we were never meant to discover the underlying mysteries of the neck’s surface anatomy. The quest first began with the cricoid cartilage and although Sellick’s maneuver1 seemed an acceptable concept, it eventually proved somewhat disappointing in its application. Who knows how often this technique actually hit its target? Now, as Hiller et al. outline in this issue of the Journal, just north of the cricoid cartilage and sorely needed for expeditious emergency surgical airway (ESA), it seems that the cricothyroid membrane (CTM) is also keeping its exact location a closely guarded secret.2 …

Sellick BA. Cricoid pressure to control regurgitation of stomach contents during induction of anaesthesia. Lancet 1961; 2: 404-6.CrossRefPubMed

Hiller KN, Karni RJ, Cai C, Holcombe JB, Hagberg CA. Comparing anesthesia provider and trauma surgeon success rates of using palpation for cricothyroid membrane identification in female subjects: a prospective observational study. Can J Anesth 2016; 63: this issue. DOI: 10.1007/s12630-016-0647-5.

Peterson GN, Domino KB, Caplan RA, Posner KL, Lee LA, Cheney FW. Management of the difficult airway: a closed claims analysis. Anesthesiology 2005; 103: 33-9.CrossRefPubMed

Frerk C, Cook T. Management of the can’t intubate can’t ventilate’ situation and the emergency surgical airway. In: Cook T, Woodall NM, Frerk C, editors. 4th National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society - Major Complications of Airway Management in the United Kingdom. Report and findings. London: Royal College of Anaesthetists; 2011 .

Frerk C, Mitchell VS, McNarry AF, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth 2015; 115: 827-48.CrossRefPubMedPubMedCentral

Law JA, Broemling N, Cooper RM, et al. The difficult airway with recommendations for management—part 1—difficult tracheal intubation encountered in an unconscious/induced patient. Can J Anesth 2013; 60: 1089-118.CrossRefPubMedPubMedCentral

Apfelbaum JL, Hagberg CA, Caplan RA, et al. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2013; 118: 251-70.CrossRefPubMed

Aslani A, Ng SC, Hurley M, McCarthy KF, McNicholas M, McCaul CL. Accuracy of identification of the cricothyroid membrane in female subjects using palpation: an observational study. Anesth Analg 2012; 114: 987-92.CrossRefPubMed

You-Ten KE, Desai D, Postonogova T, Siddiqui N. Accuracy of conventional digital palpation and ultrasound of the cricothyroid membrane in obese women in labour. Anaesthesia 2015; 70: 1230-4.PubMed

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Bair AE, Chima R. The inaccuracy of using landmark techniques for cricothyroid membrane identification: a comparison of three techniques. Acad Emerg Med 2015; 22: 908-14.CrossRefPubMed

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Kristensen MS, Teoh WH, Rudolph SS, et al. Structured approach to ultrasound-guided identification of the cricothyroid membrane: a randomized comparison with the palpation method in the morbidly obese. Br J Anaesth 2015; 114: 1003-4.CrossRefPubMed

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Dillon JK, Christensen B, Fairbanks T, Jurkovich G, Moe KS. The emergent surgical airway: cricothyrotomy vs. tracheotomy. Int J Oral Maxillofac Surg 2013; 42: 204-8.CrossRefPubMed

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Levitan R. Available from: URL: http://www.airwaycam/cricothyrotomy/ (accessed February 2016).

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Kristensen MS. Ultrasonography in the management of the airway. Acta Anaesthesiol Scand 2011; 55: 1155-73.CrossRefPubMed

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Law JA, Broemling N, Cooper RM, et al. The difficult airway with recommendations for management—part 2—the anticipated difficult airway. Can J Anesth 2013; 60: 1119-38.CrossRefPubMedPubMedCentral

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Brindley PG, Beed M, Duggan LV, Hung O, Murphy MF. Updating our approach to the difficult and failed airways: time to “stop and think”. Can J Anesth 2016; DOI: 10.1007/s12630-016-0594-1.PubMed

Titel: Deficiencies in locating the cricothyroid membrane by palpation: We can’t and the surgeons can’t, so what now for the emergency surgical airway?
verfasst von: J. Adam Law, MD
Publikationsdatum: 05.05.2016
Verlag: Springer US
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 7/2016
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-016-0648-4

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Deficiencies in locating the cricothyroid membrane by palpation: We can’t and the surgeons can’t, so what now for the emergency surgical airway?

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