A randomized cross-over study comparing surgical cricothyrotomy techniques by combat medics using a synthetic cadaver model

Steven G. Schauer, Jessie Renee Jessie, Jamie L. Roper, Derek Brown, Kristine L. Jeffers, Jonathan Srichandra, Neil B. Davids, Michael D. April

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective: Cricothyrotomy is a complex procedure with a high rate of complications including failure to cannulate and injury to adjacent anatomy. The Control-Cric™ System and QuickTrach II™ represent two novel devices designed to optimize success and minimize complications with this procedure. This study compares these two devices against a standard open surgical technique. Methods: We conducted a randomized crossover study of United States Army combat medics using a synthetic cadaver model. Participants performed a surgical cricothyrotomy using the standard open surgical technique, Control-Cric™ System, and QuickTrach II™ device in a random order. The primary outcome was time to successful cannulation. The secondary outcome was first-attempt success. We also surveyed participants after performing the procedures as to their preferences. Results: Of 70 enrolled subjects, 65 completed all study procedures. Of those that successfully cannulated, the mean times to cannulation were comparable for all three methods: standard 51.0 s (95% CI 45.2–56.8), QuickTrach II™ 39.8 s (95% CI 31.4–48.2) and the Cric-Control™ 53.6 (95% CI 45.7–61.4). Cannulation failure rates were not significantly different: standard 6.2%, QuickTrach II™ 13.9%, Cric-Control™ 18.5% (p = 0.106). First pass success rates were also similar (93.4%, 91.1%, 88.7%, respectively, p = 0.670). Of respondents completing the post-study survey, a majority (52.3%) preferred the QuickTrach II™ device. Conclusions: We identified no significant differences between the three cricothyrotomy techniques with regards to time to successful cannulation or first-pass success.

Original languageEnglish (US)
Pages (from-to)651-656
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume36
Issue number4
DOIs
StatePublished - Apr 2018
Externally publishedYes

Keywords

  • Airway
  • Cricothyrotomy
  • Military
  • Prehospital
  • Surgical

ASJC Scopus subject areas

  • Emergency Medicine

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