Emergency surgical airway through cricothyroid membrane when CICO — 'can't intubate, can't oxygenate' — occurs. Educational overview only.
Indications
- • CICO scenario
- • Failed intubation with hypoxia
Contraindications
- ⚠ Age <8 (needle cricothyrotomy preferred)
- ⚠ Laryngeal fracture
Equipment
- • Scalpel #10
- • Bougie
- • Size 6.0 ETT or trach
- • Retractor / hook
Positioning
- • As appropriate for the procedure and patient comfort.
Consent
- • Explain indication, benefits, alternatives
- • Explain risks & complications
- • Obtain written/verbal consent as per SOP
- • Document consent
Universal precautions
- • Hand hygiene
- • PPE — gloves, mask, eye protection
- • Aseptic technique
- • Sharps safety
- • Verify patient identity & site
Step-by-step (0/6)
Tap to complete
Cricothyroid membrane between thyroid & cricoid cartilage.
Immediate complications
- ⚠ Bleeding
- ⚠ False passage
- ⚠ Esophageal injury
- ⚠ Barotrauma
Delayed complications
- • Subglottic stenosis
- • Voice change
Recognition
- • No ETCO2
- • SC emphysema
Initial management
- • Reposition or convert to tracheostomy
Prevention
- • Practice; landmark identification
Post-procedure observation
- • Vitals q15min × 1h then hourly
Monitoring
- • Site inspection
- • Symptom review
Documentation
- • Procedure note
- • Consent
- • Findings
Patient instructions
- • Report pain, bleeding, fever, worsening symptoms
Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.
