Surgical Management Of the Failed Airway: A guide to precutaneous cricothyrotomy

Surgical Management Of the Failed Airway: A guide to precutaneous cricothyrotomy

Guidelines from Hoan E. Spiegel, MD
Assistant Professor
Beth Israel Ddeaconess Medical Center
Harvard medical School Boston, MS

Vipul Shah, MD
Western Washington Medical Group
Everett, Washington

The first-known mention of an attempted surgical airway, a tracheostomy, was depicted on Egyptian tablets as early as 3600 BCE. History has condemned the emergent surgical airway when it has failed, but when successful, the physicians who performed it have risen in esteem to become “on a footing with the gods”.

Il 100 BCE, the Persian physician Asclepiades described in detail a tracheal incision for improving the airway. Yet most who advocated surgical approaches to the airway, including Asclepiades, were severely criticized. Vicq d’Azyr, a French surgeon and anatomist, first described cricothyrotomy in 1805. Emergent cricothyroidotomy (also known as cricothyrotomy, minitracheostomy, and high tracheostomy) became widely acknowledged and accepted in 1976 when Brantigan and Grow confirmed the relative safety of the procedure. A decade later, the Seldinger technique, a wire-over-needle procedure commonly used for intra-vascular cannulation, was adapted for use in obtaining both emergent and nonemergent surgical airways.

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Emergency Live

Emergency Live is the only multilingual magazine dedicated to people involved in rescue and emergency. As such, it is the ideal medium in terms of speed and cost for trading companies to reach large numbers of target users; for example, all companies involved in some way in the equipping of specialised means of transport. From vehicle manufacturers to companies involved in equipping those vehicles, to any supplier of life- saving and rescue equipment and aids.

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