- The incidence of anesthesia related “can’t intubate, can’t oxygenate” is about 1:50,000. It is a rare crisis scenario for which anesthesia professionals should be informed of the various techniques for neck airway access.
- In this simulation study of a manikin with impalpable anatomy and bleeding, the authors evaluated time to oxygen delivery and success rates among 65 anesthesiologists between two neck airway access techniques, scalpel-finger-cannula and scalpel-finger-bougie cricothyrotomy.
- In successful cricothyrotomies, the authors found that time to oxygenate was significantly shorter for the scalpel-finger-cannula technique (125 seconds), with a median time difference of approximately one minute.
- A significant finding was neither neck airway access techniques were 100% successful (defined as neck airway access within 3 attempts or 3 minutes), with the overall success of the scalpel-finger-cannula technique at 86%, verse 63% for the scalpel-finger-bougie technique.
- The authors concluded that the scalpel-finger-cannula technique is faster but cricothyrotomies take more time than one might imagine and is often unsuccessful within 3 attempts and 3 minutes – even in a manikin study setting with all the necessary equipment available.
Summary of "Success and Time to Oxygen Delivery for Scalpel-Finger-Cannula and Scalpel-Finger-Bougie Front-of-Neck Access: A Randomized Crossover Study With a Simulated “Can’t Intubate, Can’t Oxygenate” Scenario in a Manikin Model With Impalpable Neck Anatomy"
Summary published January 12, 2023