Percutaneous Cricothyroidotomy: Cut First, Poke Later

In a randomized crossover study, researchers compared an incision-first modification of the percutaneous Seldinger technique for cricothyroidotomy to the conventional needle-first approach. Thirty attending and resident emergency medicine physicians in Canada each performed the procedures three times using validated, high-fidelity, simulated trachea models consisting of porcine tracheas covered by full-thickness skin and subcutaneous tissue. The needle-first technique involved inserting a needle into the cricoid membrane while aspirating for air, feeding a wire through the needle, then following the remaining steps of the Seldinger technique to insert the tube. The incision-first model involved a 2 cm vertical incision deep enough to expose…