Journal Club Summary Cricothyroidotomy

Methodology Score: 3/5                      
Usefulness Score: 2/5
Kanji H, Thirsk W, Dong S, Szava-Kovats M, Villa-Roel C, Singh M, Rowe BH.
Acad Emerg Med. 2012 Sep;19(9):E1061-E1067.
This was a randomized crossover trial comparing needle (seldinger) Cricothyroidotomy (NF) with a new technique that utilizes the initial surgical vertical incision to find the cricothyroid membrane before using the seldinger technique to enter the trachea (IF) in a swine model. They found a statistically significant difference in time to intratracheal placement of the 8.5F cordis (53sec vs 90sec). JC attendees questioned the clinical significance of the time differences, as well as the model used (i.e. a non-bleeding model for a trial using the surgical incision). The conclusion was that this was an interesting technique but it would be useful to examine it further in a) a bleeding model, and b) not directly after a learning session about the technique.  
By: Dr.  Christa Dakin