Update: Some of the Stuff Here is now Outdated, Come to Podcast 131 for the cric redux
Ok, Ok, I promise this is the last airway episode for at least a little while. I am perhaps a bit obsessed. Had this show in the works for a while. The cric is the last barrier between a failed airway and death. EM docs need to be able to perform this procedure without hesitation. This requires training and practice until you can perform the procedure in < 30 seconds literally with your eyes closed!
On this show:
Since you need to practice and patients get a wee bit pissed if they wake up with an unnecessary, unexpected tube in their neck, you need something to train on. Pig trachs smell and are not great training IMNSHO. Instead, read this article:
Anaesthesia 2004;59:1012
Here is the picture
With this set-up, which costs nothing, you can practice as many times as necessary any time you like. You'll see my version of the set-up in my video below.
I prefer surgical crics. I think wire-based seldinger kits fail badly when stress is involved. That is opinion. They are also entirely too slow; that is FACT.
Anaesth Anal 2010;110(4):1083 & Anaesthesia 2006;61:565
This stuff has also been updated here:
Podcast 231 – How to Practice Cricothyroidotomy (Cric)
Here is a video with the three techniques I prefer for crics
See episode 131 for how I recommend performing this procedure now
Additional New Information
More on EMCrit
EMCrit 131 – Cricothyrotomy – Cut to Air: Emergency Surgical Airway(Opens in a new browser tab)
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Professor
Nassau University Medical Center
No conflicts of interest (coi).
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