Document Detail


A laboratory comparison of emergency percutaneous and surgical cricothyrotomy by prehospital personnel.
MedLine Citation:
PMID:  15626006     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the speeds and success rates of placement for percutaneous cricothyrotomy versus surgical or open cricothyrotomy. METHODS: Twenty-two paramedics (mean 9.7 years of experience), with training in both methods, were timed using a pig trachea in a crossover model. An emergency physician performed timing and documentation of success; timing commenced after the equipment was ready and the membrane was identified. Paramedics were randomly assigned by a coin toss to start in either group. All were actively employed by a municipal third-service emergency medical services (EMS) agency. Paramedics who did not complete one of the methods correctly were excluded from speed analysis. Data were analyzed using descriptive statistics, a t-test of paired samples, and confidence intervals for matched samples. RESULTS: Placement of a surgical cricothyrotomy was significantly faster (mean 28 seconds, range 10-78 seconds) than the percutaneous method (mean 123 seconds, range 58-257 seconds) (p < 0.001). Mean difference between the 20 matched percutaneous versus surgical pairs was 93.75 seconds (95% CI 72.3, 115.2). The surgical route had a 100% success rate at obtaining airway control, whereas the percutaneous method had a 90.9% success rate (p = 0.1). CONCLUSION: In an animal model, surgical cricothyrotomy appeared to be a preferable method for establishing a definitive airway over the percutaneous method. Further research is required to define the optimal approach in the prehospital setting for the invasive airway.
Authors:
Michelle Fischer Keane; Kathryn H Brinsfield; K Sophia Dyer; Simon Roy; Daniel White
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors     Volume:  8     ISSN:  1090-3127     ISO Abbreviation:  Prehosp Emerg Care     Publication Date:    2004 Oct-Dec
Date Detail:
Created Date:  2004-12-31     Completed Date:  2005-02-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9703530     Medline TA:  Prehosp Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  424-6     Citation Subset:  IM    
Affiliation:
Boston Medical Center and Boston Emergency Medical Services, Boston, Massachusetts 02118-2525, USA. keane_m@bostonems.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Animals
Cross-Over Studies
Emergency Medical Services*
Emergency Medical Technicians*
Female
Humans
Male
Middle Aged
Prospective Studies
Swine
Time Factors
Tracheotomy / methods*

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


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