# Cricothyroidotomy in extreme emergency: A case report of a real-life experience in three steps and less than 30 s using a single blade

## TL;DR

This paper describes a fast cricothyroidotomy technique using a single blade and hands, successfully used in an emergency for a patient with unusual anatomy.

## Contribution

A novel three-step cricothyroidotomy method requiring minimal tools and less than 30 seconds is introduced.

## Key findings

- The procedure was completed in under 30 seconds using a single blade and manual dissection.
- The technique worked effectively despite the patient's anatomical deformities.
- The semi-reclined position improved the efficiency of the procedure.

## Abstract

Cricothyroidotomy is often the last resort when conventional ventilation devices prove ineffective. The conventional procedure that involves several steps and requires the completion of a preoperative checklist. This report describes a novel approach to cricothyroidotomy, allowing quick access to the cricothyroid membrane in fewer steps.

We present the case of a 26-year-old male with Schimmelpenning syndrome, exhibiting significant anatomical deformity. Following surgery for temporomandibular joint replacement, the patient developed a hematoma requiring urgent intervention. During nasotracheal intubation, the patient experienced a significant drop in oxygen saturation, which required prompt cricothyroidotomy. The procedure was performed in less than 30 s using a single blade for incising the tissues and the surgeon's hands for dissection and retraction. The procedure resulted in immediate recovery of the patient's oxygen saturation.

In contrast to previously reported multi-step procedures, this study reports a simpler three-step cricothyroidotomy. The technique involves a vertical skin incision, blunt dissection using the surgeon's fingers, and a horizontal incision on the cricothyroid membrane. The procedure was executed with the patient in a semi-reclined position, optimizing time efficiency.

This case highlights the efficacy of a rapid cricothyroidotomy technique in extreme emergencies. The presented technique requires minimal instrumentation and can be completed quickly in an emergency situation, even in the presence of anatomical variations.

•We present a quick cricothyroidotomy technique executed in less than 30 s.•The technique required the use of a single blade and the surgeon's hands.•The technique proved effective even in a case of atypical anatomy.•The procedure could be performed in a semi-reclined position, improving efficiency.

We present a quick cricothyroidotomy technique executed in less than 30 s.

The technique required the use of a single blade and the surgeon's hands.

The technique proved effective even in a case of atypical anatomy.

The procedure could be performed in a semi-reclined position, improving efficiency.