What is Surgical Cricothyrotomy?
At Medical Education and Dynamic Instructions Consultants we offer advanced procedure cadaver courses and custom education classes tailored to each clients needs. Difficult airways continue to challenge providers at all certification levels. All of MEDiC’s instructors are airway management experts and have a passion for airway management education.
Surgical Cricothyrotomy competency is essential as all airway algorithms can end with a Surgical Cricothyrotomy. At MEDiC we take a minimal equipment approach to Surgical Cric that can be accomplished in almost any emergency patient care setting. With a Bougie, scalpel and 6.0 ETT, a Surgical Cric can be performed in less than 30 seconds.
During our cadaver labs every clinician is given the opportunity to practice this potentially life saving skill. Between the instructors, we have performed almost a dozen Surgical Crics. The procedure is broken down each step to make the procedure simple and approachable. Our ultimate goal is to give our students the confidence to execute this procedure when the need arises.
The Procedure
The procedure is accomplished by first making a vertical incision followed by horizontal incision. Next, your dominant hand holds the scalpel while the non-dominant hand locates the cricothyroid membrane. The clinicians then makes a generous midline incision over the previously located cricothyroid membrane; followed by a horizontal incision to open the cricothyroid membrane. Next the clinician inserts their finger through the opening in the cricothyroid membrane. Then, place a bougie in the opening using the finger as a guide then pass a 6.0 ETT over the bougie into the trachea. Inflate the cuff and confirm placement via ETCO2 and BVM. Finally, ensure that the ETT is secure by using tape or a commercial securing device.
Why use Cadaveric Specimens?
Traditional rubber simulation mannequins are useful to aid in learning the basic procedure steps, however these mannequins do not do a great job of conveying actual tissue feel. Our fresh, never embalmed cadavers provide the student with an experience that is comparable to the real procedure. Cadaveric tissue most accurately represents live tissue feel to the scalpel user. Additionally, we perform a full anatomical neck dissection post procedure to better help the students visualize and understand the anatomy of the neck and airway. This helps to entrench the anatomical features into the mind of the student, in a way that mannequins or books cannot.
The below video provides a simultaneous depiction of the internal and external view of a surgical cricothyrotomy. We believe this dual view of the procedure aids in understanding and in turn retention and proficiency.
Demonstration Video
https://drive.google.com/file/d/11uK1M4W1gea4ynoVk7KhL71sdPaVh0If/view?resourcekey
Why MEDiC?
Our educators have a passion for emergency management and critical care education. Between our three primary educators, we have over 40 years of prehospital and emergency medicine experience. This experience wasn’t just obtained in a nice, well lit, operating room. This is experience obtained by performing emergent airways (including Surgical Crics) on the sides of highways, often in the dark. All of our educators have at least one airway publication credit to their name.
