Fifty-four emergent cricothyroidotomies: Are surgeons reluctant teachers?

D. King*, M. Ogilvie, M. Michailidou, G. Velmahos, H. Alam, M. deMoya, K. Fikry

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background: Emergent cricothyroidotomy remains an uncommon, but life-saving, core procedural training requirement for emergency medicine (EM) physician training. We hypothesized that, although most cricothyroidotomies occur in the emergency department (ED), they are rarely performed by EM physicians. Methods: We conducted a retrospective analysis of all emergent cricothyroidotomies performed at two large level one trauma centers over 10 years. Operators and assistants for all procedures were identified, as well as mechanism of injury and patient demographics were examined. Results: Fifty-four cricothyroidotomies were performed. Patients were: mean age of 50, 80% male and 90% blunt trauma. The most common primary operator was a surgeon (n = 47, 87%), followed by an Emergency Medical Services (EMS) provider (n = 6, 11%) and a EM physician (n = 1, 2%). In all cases, except those performed by EMS, the operator or assistant was an attending surgeon. All EMS procedures resulted in serious complications compared to in-hospital procedures (p < 0.0001). Conclusions: 1. Pre-hospital cricothyroidotomy results in serious complications. 2. Despite the ubiquitous presence of emergency medicine physicians in the ED, all cricothyroidotomies were performed by a surgeon, which may represent a serious emergency medicine training deficiency.

Original languageEnglish (US)
Pages (from-to)13-15
Number of pages3
JournalScandinavian Journal of Surgery
Volume101
Issue number1
DOIs
StatePublished - Mar 2012
Externally publishedYes

Keywords

  • Cricothyroidotomy
  • Emergency medicine
  • Surgical airway
  • Tracheostomy
  • Trauma surgery

ASJC Scopus subject areas

  • Surgery

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