Cricothyroidotomy for Can’t Intubate, Can’t Oxygenate Situation in Emergency Department

TL;DR

This paper discusses the use of cricothyroidotomy in emergency airway management when intubation and oxygenation fail.

Contribution

The paper contributes a real-life case and emphasizes the importance of training and preparedness for rare but critical procedures.

Findings

Bougie-assisted cricothyroidotomy successfully managed a CICO situation in a tetanus patient.

Simulation training and equipment readiness are crucial for successful outcomes.

Skill maintenance is essential for emergency care professionals.

Abstract

Airway emergencies represent some of the most time-critical and high-stress situations in emergency and critical care practice. Cricothyroidotomy, though infrequently performed, remains the definitive lifesaving procedure when conventional airway management fails in a “cannot intubate, cannot oxygenate” (CICO) scenario. This viewpoint discusses a real-life experience of performing bougie-assisted cricothyroidotomy in a patient with tetanus-induced trismus, reviews the technical aspects of the procedure, and highlights the importance of preparedness, simulation training, and equipment readiness. Despite its rarity, the procedure’s successful execution can be the difference between life and death, emphasizing the need for continuous skill maintenance among emergency and critical care professionals.