Cricothyrotomy

1. ODESSA NATIONAL MEDICAL
UNIVERSITY
SIMULATION MEDICINE
CONICOTOMY
9TH TOPIC
Karwan Khasro Ahmed
6th Course
1st Group

2. SURGICAL AIRWAY MANAGEMENT
Cricothyrotomy (Conicotomy)
Definition: emergency procedure in which an incision is made through the skin
and mediancricothyroid ligament (cricothyroid membrane) to obtain airway access

3. INDICATIONS
• Indications: 'cannot-intubate-cannot-ventilate' (CICV) scenario (if orotracheal
intubation has failed or is contraindicated)
• Angioedema
• Foreign body in upper airway
• Severe oropharyngeal/nasal bleeding
• Severe maxillofacial trauma

4. CONTRAINDICATIONS
• Inability to identify anatomical landmarks
• Tumor or infection at the incision site
• Laryngeal fracture

5. PROCEDURE
• Surgical incision or over-the-needle catheter insertion (needle cricothyrotomy)
• An incision is made into the skin, superficial cervical fascia, investing
layer of deep cervical fascia, pre-tracheal fascia, and finally the
membranous cricothyroid space, followed by insertion of a catheter

6. COMPLICATIONS
• Bleeding
• Subcutaneous emphysema
• Esophageal, mediastinal, tracheal, or thyroidperforation
• Vocal cord injury
• Recurrent laryngeal nerve injury
• Pneumothorax
• Late complications: dysphonia, scarring, stenosis, tracheomalacia

7. THANKS FOR YOUR ATTENTION