• James Dinsmore, Andrew M B Heard, and Richard J Green.
• Southampton General Hospital, Southampton, Hampshire, UK.
• Eur J Anaesthesiol. 2011 Jul 1;28(7):506-10.

Background And ObjectiveTranstracheal or transcricothyroid placement of a cannula is a practice used in a number of aspects of airway management in anaesthesia and intensive care. In this study, we aimed to investigate whether the use of ultrasound will facilitate cannula placement in a time-critical situation in patients with difficult anterior neck airway anatomy.MethodFifty anaesthetists were randomised to either ultrasound-guided or conventional unguided attempts, at cannula insertion into a model simulating a patient with unidentifiable anterior neck anatomy. Endpoints were the success, and time to success, of cannula placement.ResultsThere was a significant increase in success rate (83 vs. 43%, P = 0.011) and a significant decrease in time to successful placement (median time to successful cannulation 57 vs. 110 s, P = 0.008) using ultrasound guided compared to unguided cannula placement.ConclusionIf a 'can't intubate, can't oxygenate' scenario occurs in a patient with unidentifiable anterior neck airway anatomy in a location where an ultrasound machine is immediately available, we recommend that consideration is given to the use of ultrasound-guided cannula tracheotomy as the first-line rescue technique.

24 keywords...

hide…