Cricothyrotomy in air medical transport.

BACKGROUND: Airway management is an essential skill for air medical transport (AMT) providers. The endpoint of airway maneuvers is a cricothyrotomy which may be live-saving if other measures fail. We reviewed cricothyrotomy cases in our AMT program to evaluate the success rate and the circumstances surrounding the procedure.

METHODS: This was a retrospective review of cases in which a cricothyrotomy was performed at the University of Utah AirMed flight program during the years of 1995 to 2004. Data included incidence, indications, complications, neurologic outcome, and success rates of the procedure.

RESULTS: Of the 14,994 transports during the study period, 17 cricothyrotomies were performed. Airway obstruction by blood and/or vomit was the most frequent indication (47%) followed by airway edema/distorted anatomy (24%). The total number of cricothyrotomies decreased during the study period. Seven (41%) patients survived with a reasonable neurologic outcome. The remaining 10 patients died during initial treatment or subsequent hospitalization. Success rate of the procedure in our series was 100%. These results were compared with those of other cricothyrotomy studies.

CONCLUSION: Cricothyrotomy has become less common as an emergency rescue technique. However, AMT personnel have a high success rate when performing the cricothyrotomy procedure. This rate is as high as or higher than other emergency personnel.