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A randomised cross-over comparison of the transverse and longitudinal techniques for ultrasound-guided identification of the cricothyroid membrane in morbidly obese subjects

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  1. From variance to guidance for awake tracheal intubation

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Depth to the airway lumen at the level of the cricothyroid membrane measured by ultrasound

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  3. Managing and securing the bleeding upper airway: a narrative review

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  4. A simple clinical assessment is superior to systematic triage in prediction of mortality in the emergency department

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  5. Preoperative ultrasound measurement of depth to the airway at the level of the cricothyroid membrane correlates with patient weight

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We compared the transverse and longitudinal approaches to ultrasound-guided identification of the cricothyroid membrane, to determine which was faster and more successful. Forty-two anaesthetists received a one-hour structured training programme consisting of e-learning, a lecture and hands-on training, and then applied both techniques in a randomised, cross-over sequence to obese females with body mass index 39.0 - 43.9 kg.m(-2) . The mean (SD) time to identify the cricothyroid membrane was 24.0 (12.4) s using the transverse technique compared with 37.6 (17.9) s for the longitudinal technique (p = 0.0003). Successful identification of the cricothyroid membrane was achieved by 38 (90%) anaesthetists using either technique. All anaesthetists were successful in identifying the cricothyroid membrane with at least one of the techniques. We advocate the learning and application of these two techniques for identification of the cricothyroid membrane before starting anaesthesia in difficult patients, especially when anatomical landmarks are impalpable. Further use in emergency situations is feasible, if clinicians have experience and the ultrasound machine is readily available.

Original languageEnglish
JournalAnaesthesia (Oxford)
Volume71
Issue number6
Pages (from-to)675-83
ISSN0003-2409
DOIs
Publication statusPublished - 2 Apr 2016

ID: 46376568