Document Detail

Comparison of conventional surgical versus Seldinger technique emergency cricothyrotomy performed by inexperienced clinicians.
MedLine Citation:
PMID:  10719947     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cricothyrotomy is the ultimate option for a patient with a life-threatening airway problem. METHODS: The authors compared the first-time performance of surgical (group 1) versus Seldinger technique (group 2) cricothyrotomy in cadavers. Intensive care unit physicians (n = 20) performed each procedure on two adult human cadavers. Methods were compared with regard to ease of use and anatomy of the neck of the cadaver. Times to location of the cricothyroid membrane, to tracheal puncture, and to the first ventilation were recorded. Each participant was allowed only one attempt per procedure. A pathologist dissected the neck of each patient and assessed correctness of position of the tube and any injury inflicted. Subjective assessment of technique and cadaver on a visual analog scale from 1 (easiest) to 5 (worst) was conducted by the performer. RESULTS: Age, height, and weight of the cadavers were not different. Subjective assessment of both methods (2.2 in group 1 vs. 2.4 in group 2) and anatomy of the cadavers (2.2 in group 1 vs. 2.4 in group 2) showed no statistically significant difference between both groups. Tracheal placement of the tube was achieved in 70% (n = 14) in group 1 versus 60% (n = 12) in group 2 (P value not significant). Five attempts in group 2 had to be aborted because of kinking of the guide wire. Time intervals (mean +/- SD) were from start to location of the cricothyroid membrane 7 +/- 9 s (group 1) versus 8 +/- 7s (group 2), to tracheal puncture 46 +/- 37s (group 1) versus 30 +/- 28s (group 2), and to first ventilation 102 +/- 42s (group 1) versus 100 +/- 46s (group 2) (P value not significant). CONCLUSIONS: The two methods showed equally poor performance.
P Eisenburger; K Laczika; M List; A Wilfing; H Losert; R Hofbauer; H Burgmann; H Bankl; B Pikula; J L Benumof; M Frass
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  92     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-03-28     Completed Date:  2000-03-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  687-90     Citation Subset:  AIM; IM    
Department of Internal Medicine I, University of Vienna, Austria.
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MeSH Terms
Emergency Medical Services*
Intensive Care Units
Larynx / anatomy & histology,  surgery*
Middle Aged
Neck / anatomy & histology
Respiratory Muscles / anatomy & histology,  surgery*
Respiratory System / surgery*
Surgical Procedures, Operative*
Thyroid Cartilage / anatomy & histology,  surgery*
Trachea / anatomy & histology,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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