Emergency airway management: What are the roles for surgical cricothyroidotomy and the Ventrain^® device?

Excerpt

The National Audit Project 4 (NAP4) data1 indicate a high failure rate for emergency airway rescue, which in my mind is not a surprise. Anesthesiologists and allied health practitioners encounter truly difficult airway scenarios infrequently - likely because of the inherently low risk of these scenarios and the practioners’ individual competence and ingenuity. When the scenarios do arise, however, it is not always possible to control the context (i.e., planning, preparation, prevention) or the preferred path to take. The final common pathway for the management of a “can’t intubate can’t oxygenate” (CICO) airway emergency involves the time-sensitive creation of a surgical airway. The rarity and uniqueness of these events combined with the aggressiveness and unfamiliarity of the techniques proposed to address the CICO situation can generate significant stress and fear, which may impair both judgement and performance. The search for a universally optimal approach to this dilemma arguably remains in its relative infancy. …