Posted by Matthew Mac Partlin on Tuesday, November 1, 2011

Emergency cricothyroidotomy is a scary beast in the resus room of a tertiary hospital ED. Having it flop down in front of you at a race event is a pant filler!

There is constant debate over the best method to use, bouncing between needle cric and scalpel cric with various versions of tube introduction. There are supporters of both approaches, with cogent arguments on both sides, as seen on the previously mentionned EM Crit debate, between ED physician Scott Weingart and anaesthetist and retrievalist Cong Le Minh (See the "Can't intubate, can't ventilate debate" blog on August 19th in Clinical Topics)

Here is another rapid approach, the IV Spike Cric,  using components of an IV giving set, that apparently originated in the military and has now been validated on unembalmed cadavers (Presumably means the tissues are not so tough - Platts-Mills TF, Lewin MR, Wells J, Bickler P; Improvised Cricothyrotomy Provides Reliable Airway Access in an Unembalmed Human Cadaver Model. Wilderness and Environmental Medicine, 17, 81-86 (2006)).

The technique is described, with good pictures on the CLIC EM website, an emergency medicine blog based in Chicago (so they probably know what they're talking about when it comes to trauma).

http://www.clicem.org/2011/10/iv-spike-cric.html?showComment=1320117339895#c2233885654897888987