Modified Cricothyroidotomy in Skill Laboratory

Introduction: Unsuccessful tracheal intubation is considered the most common cause of anesthesia death or brain damage. This study delineates our experience recommending modifications in the cricothyroidotomy technique .Methods: Thirty emergency medicine residents of participated in a study performed on the human simulator moulage in Skill Laboratory of Tabriz University of Medical Science. The cricothyroid membrane was punctured using a 16-gauge cannula. Later, J guide wire was advanced into trachea and standard 16-gauge intravenous cannula with a removable needle stylet withdrawn after the puncture being dilated by a dilator. Consequently, a cuffed tracheal tube (ID= 6) was introduced from the foramen. Results: From 30 residents, 18 residents performed cricothyroidotomy within 1 minute, 7 residents in 2 minutes and 5 residents failed to fulfill the procedure. Conclusion: Several studies using cadavers and human simulators have demonstrated the pre-hospital feasibility of this technique. However, descriptions of clinical pre-hospital experience with percutaneous cricothyroidotomy are limited. This study shows that skill lab may help residents to acquire techniques required in management of difficult airway.