Locating the cricothyroid membrane in males: Influence of the morphological characteristics of the neck.

INTRODUCTION

Cricothyrotomy is a recommended technique to restore oxygenation in most of guidelines for difficult airway management. A correct location of the cricothyroid membrane (CTM) is fundamental for a proper performance of the technique. Several studies have shown poor accuracy with the identification the CTM by palpation, resulting in a high failure rate of the technique.

OBJECTIVE

The aim of this study was to determine the impact of the patient's neck morphology on the accurate location of the CTM and on the time employed.

MATERIALS AND METHOD: Observational study in which anaesthesiologists and intensivists voluntarily participated in a simulation that consisted of a «cannot intubate, cannot oxygenate» scenario, where they had to locate the CTM, as soon as possible, in 2 selected male patients with different morphological characteristics of the neck. The time was measured from the beginning of CTM palpation to locating it with a marker.

RESULTS AND

CONCLUSIONS

A higher body mass index and a higher neck circumference correlated with a 70% location failure rate and with a longer time as compared with a standard model.