Cricothyrotomy remains one of the most important salvage airway techniques available
to the emergency physician; however, our competence with endotracheal intubation has
led to a decline in our familiarity with surgical airway procedures. This has resulted
in the development of multiple devices and techniques to simplify the procedure and
avoid complications such as bleeding or intubation of a false lumen. The Rapid Four-Step
Technique (RFST) uses a stab incision followed by inferior traction on the cricoid
cartilage to mimic the kinesthetics of direct laryngoscopy (
1
,
2
). As Dr. Bair points out, however, the cricoid cartilage appears to be more prone
to fracture or laceration with application of traction using a single hook. We demonstrated
this phenomenon in a cadaver model (
3
). Dr. Bair developed his device as an adjunct to RFST, with our follow-up analysis
revealing that it eliminated cricoid injury in the same cadaver model (
4
).To read this article in full you will need to make a payment
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References
- An easy cricothyrotomy approach.Acad Emerg Med. 1996; 3: 1060-1063
- Comparison of 2 cricothyrotomy techniques.Ann Emerg Med. 1998; 32: 442-446
- Cricothyrotomy technique.J Emerg Med. 1999; 17: 17-21
- Safety and efficacy of the rapid four-step technique for cricothyrotomy using a Bair Claw.J Emerg Med. 2000; 19: 125-129
Bramwell KJ, Davis DP, Cardall TV, Yoshida E, Vilke GM, Rosen P. Use of the Trousseau dilator in cricothyrotomy. J Emerg Med 1999;17:433–6.
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© 2001 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.
