Prehospital cricothyroidotomy by physicians

Am J Emerg Med. 1997 Jan;15(1):91-3. doi: 10.1016/s0735-6757(97)90059-0.


To evaluate cricothyroidotomy in the field and the influence of physicians' medical specialty or previous experience on the success rate of this procedure, a retrospective study was conducted. Between October 1991 and April 1995, 29 cricothyroidotomies were performed in the prehospital setting in Israel. Twenty-six (89.6%) cricothyroidotomies were successfully performed. There was no evidence of higher success rate when the performers were surgeons, anesthesiologists, or intensive care specialists (100% success), compared to that of all other specialties (83.33%). All physicians had successfully completed the Advanced Trauma Life Support (ATLS) course, but only three had previously performed cricothyroidotomy. Acute complications included failure to establish an airway in 3 cases, minor bleeding in 2 cases, and an air leak around the cannula in 1 patient. These results show that following brief training (eg, the ATLS course) physicians are capable of performing emergency cricothyroidotomy in the field with a high success rate and minimal complications, regardless of medical specialty.

MeSH terms

  • Adult
  • Airway Obstruction / surgery*
  • Cricoid Cartilage / surgery*
  • Emergency Medical Services / standards*
  • Humans
  • Israel
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome