Emergency airway puncture
| Normal anatomy |
The larynx is a tubular structure in the neck, through which air passes to the lungs. The thryoid and cricoid cartilage form the narrowest section of this airway.
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| Indications |
The area of the larynx bounded by the thyroid and cricoid cartilage is a frequent site for obstruction, either by swallowed foreign bodies or abnormal tissue growths. A cricothyrotomy is an emergency procedure that relieves an airway obstruction until formal surgical placement of a breathing tube (tracheostomy) is performed.
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| Incision |
If the situation is acute, a hollow needle is inserted into the throat, just below the Adam's apple (thyroid cartilage). This is called a needle cricothyrotomy. More frequently, a small incision is made in the skin over the cricothyroid membrane, and another incision is made through the membrane between the cricoid and thyroid cartilage.
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| Procedure |
A tube that enables breathing is inserted through the incision.
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| Aftercare |
Cricothyrotomy is generally followed by a surgical tracheosotomy, if there is need for a prolonged use of a breathing tube. Removal of breathing tubes from both a cricothyrotomy and tracheostomy is usually followed by prompt healing of the incision site.
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Review Date:
7/19/2009
Reviewed By:
Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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