Surgical Cricothyrotomy in the Field

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Abstract
A retrospective analysis of 3,5000 helicopter missions revealed 20 patients who required cricothyrotomy in the field for emergency airway access. Five patients who were in caradiopulmonary arrest succumbed despite cricothyrotomy, all with adequate airway control (Trauma Score, 2.8; ISS, 55.6). Seven of 12 patients with oral, maxillofacial, or cervical trauma survived (Trauma Score, 9.6; ISS, 48.25). There were no instances of bleeding, malposition, airway obstruction, or dysphonia after decannulation in the survivors. Autopsy revealed no serious airway pathology or compromise in those who expired. Surgical cricothyrotomy can successfuly be performed in the field by a nurse/physician helicopter transport team. When concentional airway maneuvers are unsuccessful we recommend cricothyrotomy for emergency airway access.

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