emergency laryngotomy

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  • preferable to tracheostomy as the cricothyroid membrane is more superficial than the trachaea
  • needs suitable blade and tube (eg ball-point pen barrel)

Procedure:

  • lie patient face up with support under the shoulders
  • if possible, get someone to hold the patient's head on the midline, which greatly improves the chance of success
  • feel for the Adam's apple (thyroid cartilage) - the cricothyroid membrane lies immediately below this and above the cricoid cartilage
  • only extend the neck when ready to operate as the movement risks converting partial to total obstruction
  • make a horizontal incision in the cricothyroid membrane and when the blood bubbles, twist the blade and introduce any available tube such as ball-point pen barrel
  • one or more large bore cannulae may also be suitable

ref: H/B of Emergencies in Gen Pract 2e, N Lawrence et al

Last reviewed 01/2018

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