Outcomes of emergency surgical airway procedures in a hospital-wide setting

Objective: To review the circumstances, complications, and outcomes of emer gency surgical airway procedures and to compare the relative merits of cric othyroidotomy and tracheotomy for airway control in a hospital-wide patient population. Study Design: Retrospective review. Methods: Patient data were obtained from the inpatient charts and electronic patient records of 35 pa tients who required an emergency surgical airway over a 6-year period at an urban medical center, Results: Emergency cricothyroidotomy and tracheotomy were successfully performed in 34 of 35 patients (97%), Orotracheal intuba tion was successfully achieved in one patient with a failed cricothyroidoto my. The overall complication rates for emergency cricothyroidotomy and trac heotomy were similar (20% and 21%, respectively). Inpatients requiring an e mergency surgical airway had a higher complication rate (32% vs. 0%) but be tter overall survival (91% vs. 46%) than patients treated in the emergency department. No long-term complications were observed from emergency cricoth yroidotomies that were not converted to tracheotomies. Conclusion: The esta blishment of an emergency surgical airway by either tracheotomy or cricothy roidotomy is effective with low overall morbidity. The need to convert ever y emergency cricothyroidotomy to a tracheotomy should be reevaluated.