Percutaneous Cricothyrotomy: Wire-Guided vs. Catheter-over-Needle

For management of a failed airway, cricothyrotomy can be lifesaving. The proprietary prepackaged Melker and QuickTrach kits include all the equipment needed to perform percutaneous cricothyrotomy, including a cuffed airway. The wire-guided Melker technique requires more steps and the catheter-over-needle QuickTrach technique requires more force to place the needle. In a randomized trial, two anesthesiologists who had practiced on manikins 1 month before the study performed percutaneous cricothyrotomy using the two devices in 16 sheep cadavers.

The Melker technique had a higher success rate than the QuickTrach technique (100% vs. 63%) and a lower complication rate (13% vs. 75%) but a longer performance time (52 vs. 32 seconds). Complications …