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

Abstract

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.

Keywords: Características morfológicas; Cricothyroid membrane; Cricothyrotomy; Cricotirotomía; Localización; Location; Membrana cricotiroidea; Neck morphology.