A cricothyrotomy (also called thyrocricotomy, cricothyroidotomy, inferior laryngotomy, intercricothyrotomy, coniotomy or emergency airway puncture) is an emergency incision through the skin and cricothyroid membrane to secure a patient's airway during certain emergency situations, such as an airway obstructed by a foreign object or swelling, a patient who is not able to breathe adequately on their own, or in cases of major facial trauma which prevent the insertion of an airway through the mouth. A cricothyrotomy is usually performed by emergency physicians, trauma surgeons, or paramedics as a last resort when control of the airway by usual means (an endotracheal tube through the mouth) have failed or are not feasible. This technique is considered easier and faster than a tracheostomy, but is only used when oral or nasal intubation is not possible. This procedure does not require manipulation of the cervical spine. However, it does require special training and authorization from local medical direction prior to being performed, depending on local medical protocols.
In Grey's Anatomy, emergency cricothyrotomy is mentioned in at least two episodes:
In the ER episode, "Reason to Believe" Dr. Kerry Weaver performs an emergency cricothyrotomy on a student. She is shooting a news segment on childhood obesity in an elementary school cafeteria when one of the students begins to choke; after the heimlich maneuver fails, she performs a cricothyrotomy with a kitchen knife and a drinking straw.
In the movie, "Playing God" (1997), David Duchovny plays a famed LA surgeon, stripped of his license due to drug abuse, who finds himself witnessesing a gun fight at a bar. He saves a mafia crime figure by performing an emergency Cricothyrotomy. This endears him with the mafia family and drives the plot forward.
In the BBC3 Medical Drama Bodies_(TV_series), the main protagonist Rob Lake, a newly appointed obstetrics and gynaecology registrar (played by Max Beesley), is called to a patient who is having difficulty breathing due to anaphylaxis. Lake calls for emergency assistance, but impatient and fearing for the patient's life decides to undertake a cricothyrotomy himself - a procedure he has not been trained in. The procedure is unsuccessful and the patient dies before help arrives. The guilt surrounding the event combined with the covering up by his consultant provides an important backdrop to the further development of the character and his relationship with his consultant.
Emergency battlefield cricothyrotomy complicated by tube occlusion.(Emergency Airway Encounters)(Case study)(Clinical report)
Jan 01, 2009; Byline: Andrew. Gallo, Bruce. Adams Emergency cricothyrotomy is a technique used to secure an otherwise compromised or...