J Emerg Med
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Randomized Controlled Trial Comparative Study Clinical Trial
Cricothyrotomy technique: standard versus the Rapid Four-Step Technique.
Standard cricothyrotomy technique uses a tracheal hook cephalad to the opening to stabilize the trachea during endotracheal (ET) tube passage. A newly described Rapid Four-Step Technique (RFST) uses the tracheal hook caudal to the opening to stabilize the trachea during ET tube passage. This experimental crossover trial compared standard cephalad tracheal hook traction to caudad traction as recommended by RFST in a cadaver model of cricothyrotomy. ⋯ There was no significant difference between maximal ET tube sizes for standard technique (median size 7.0, mean 6.95 mm internal diameter) versus RFST (median size 7.0, mean 6.82 mm internal diameter). We conclude that RFST may be associated with a higher incidence of complications than standard technique as demonstrated by our cadaver model of cricothyrotomy. We were unable to demonstrate a difference between the two techniques with regards to size of ET tube able to be passed.