Monday, March 16, 2015

CRICKEY FASTER AND MORE SUCCESSFUL FIRST-PASS CRICOTHYROIDOTOMY





FASTER AND MORE SUCCESSFUL FIRST-PASS CRICOTHYROIDOTOMY WITH CRICKEY











Mabry RL et al. Ann Emerg Med. 2014 Jan;63(1):1-5.

ABSTRACT

STUDY OBJECTIVE: The CricKey is a novel surgical cricothyroidotomy device combining the functions of a tracheal hook, stylet, dilator, and bougie incorporated with a Melker airway cannula. This study compares surgical cricothyroidotomy with standard open surgical versus CricKey technique.

METHODS: 

This was a prospective crossover study using human cadaveric models. Participants included US Army combat medics credentialed at the emergency medical technician-basic level. After a brief anatomy review and demonstration, participants performed in random order standard open surgical cricothyroidotomy and CricKey surgical cricothyroidotomy. The primary outcome was first-pass success, and the secondary outcome measure was procedural time.

RESULTS: 

First-attempt success was 100% (15/15) for CricKey surgical cricothyroidotomy and 66% (10/15) for open surgical cricothyroidotomy (odds ratio 16.0; 95% confidence interval 0.8 to 326). Surgical cricothyroidotomy insertion was faster for CricKey than open technique (34 versus 65 seconds; median time difference 28 seconds; 95% confidence interval 16 to 48 seconds).

CONCLUSION: 

Compared with the standard open surgical cricothyroidotomy technique, military medics demonstrated faster insertion with the CricKey. First-pass success was not significantly different between the techniques.

COMMENTS

In this prospective cross-over study the CricKey had higher first-pass successrate over the standard open surgical method and was performed in less time. The CricKey is essentially a tracheostomy tube with a bougie preloaded into it. This was based on previous studies that demonstrate better performance with a bougie-guided cric. A photo of it can be seen here.








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