• Am J Emerg Med · Jan 2014

    Accuracy of ultrasound-guided marking of the cricothyroid membrane before simulated failed intubation.

    • Michael Mallin, Keith Curtis, Matthew Dawson, Patrick Ockerse, and Matthew Ahern.
    • Am J Emerg Med. 2014 Jan 1; 32 (1): 61-3.

    BackgroundInterest in the use of dynamic ultrasound (US) for cricothyrotomy has sparked a debate regarding its applicability in a crash airway situation. Ultrasound-guided marking of the cricothyroid membrane (CTM) as a preintubation procedure may be better than the dynamic method. No prior study has evaluated the accuracy of using US to premark the CTM before attempted intubation.ObjectivesTo determine the feasibility of US-guided marking of the CTM before attempted simulated intubation so that this marking may be used as the location for the initial incision after failed intubation.MethodsResident and attending physicians participated. Ultrasound was used to identify and mark the CTM with an invisible pen. Failed intubation was simulated, and the same operator then identified the CTM with US and marked the location with a black pen. The difference in the preintervention and postintervention markings was measured in millimeters. The length of the CTM was also measured as a reference.ResultsTwenty-three models and operators were used for data collection. The average CTM sagittal length was 13.9 mm (95% confidence interval [CI], 13.4-14.4). The average sagittal and axial differences before and after simulated intubation were found to be 0.91 mm (95% CI, 0.35-1.47) and 1.04 mm (95% CI, 0.38-1.7), respectively. The sagittal variability is 1/15 the total length of the CTM.ConclusionsUltrasound marking of the CTM of healthy volunteers before simulated intubation accurately identifies the CTM after neck manipulation expected during a failed intubation. Further research is indicated to determine the clinical applicability of this model.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.