Comparison of wire-guided cricothyrotomy versus standard surgical cricothyrotomy technique

We compared a wire-guided cricothyrotomy technique vs. standard surgical cr icothyrotomy in terms of accuracy in placement, complications, performance time, incision length, and user preference, We conducted a randomized, cros sover controlled trial in which Emergency Medicine (EM) attendings and resi dents performed cricothyrotomies by both standard and wire-guided technique s (using a commercially available kit) on human cadavers after a iii-min tr aining session. Procedure time, incision length, and physician preference w ere recorded. Cadavers were inspected for accuracy of placement and complic ations. Airway placement was accurate in 13 of 15 cases for the standard te chnique (86.7%), and 14 of 15 cases for the wire-guided technique (93.3%). When comparing wire-guided vs. standard techniques, there were no differenc es in complication rates or performance times. The wire-guided technique re sulted in a significantly smaller mean incision length than the standard te chnique (0.53 vs, 2.53 cm, respectively, p < 0.0001). Overall, 14 of 15 phy sicians stated that they preferred the wire-guided to the standard techniqu e. Our data suggest that this wire-guided cricothyrotomy technique is as ac curate and timely to use as the standard technique and is preferred by our physician operators. In addition, the technique results in a smaller incisi on on human cadaver models, (C) 1999 Elsevier Science Inc.