EMERGENCY CRICOTHYROTOMY - A REASSESSMENT

The Medical College of Georgia Level I Trauma Center admitted 5603 adu lt trauma patients from January 1, 1989 through June 30, 1993. Cricoth yrotomy was required in 66 of 525 patients who required emergency airw ay control but could not be intubated nonsurgically in an expeditious manner. There were three major complications (thyroid cartilage lacera tion, significant hemorrhage, and failure to obtain a surgical airway) involving two patients, but each resolved without sequelae. Twenty-si x patients with cricothyrotomy survived their hospital course, of whic h seven had decannulation of the cricothyrotomy without further airway procedures, and 19 had conversion to tracheostomy. No patient had cli nically significant morbidity from the cricothyrotomy, whether with or without a subsequent tracheostomy. Surgical cricothyrotomy remains an important technique with low morbidity for selected trauma victims ne eding emergency airway control.