Knowing when to perform cricothyrotomy

Cricothyrotomy is the way to definitively secure the airway of a dying patient (who can't be intubated or ventilated) by cutting a hole through the neck and placing a breathing tube directly into the bronchus.

There are four indications for the cricothyrotomy procedure:

1. Upper airway obstruction
2. Laryngeal spasm
3. Trismus
4. Trauma

There are three important contraindications for the cricothyrotomy procedure:

1. There is an alternative and less invasive way to secure the airway.
2. Your patient is younger than eight years old (underdeveloped cricothyroid membrane).
3. The obstruction is below the cricothyroid membrane.

Consent is not possible for cricothyrotomy unless you anticipate a difficult airway before a patient is paralyzed for intubation.

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