Accuracy of pediatric cricothyroid membrane identification by digital palpation and implications for emergency front of neck access

Background Emergency front of neck access in a “can't intubate can't oxygenate” scenario in pediatrics is rare. Ideally airway rescue would involve the presence of an ear, nose, and throat surgeon. If unavailable however, responsibility lies with the anesthesiologist and accurate identific...

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Bibliographic Details
Published in:Pediatric anesthesia 2020-01, Vol.30 (1), p.69-77
Main Authors: Fennessy, Paul, Walsh, Bill, Laffey, John G., McCarthy, Kevin F., McCaul, Conan L., Ungern‐Sternberg, Britta
Format: Article
Language:English
Subjects:
Accuracy
Adolescent
Anesthesiologists
Child
Child, Preschool
Cricoid Cartilage - anatomy & histology
Cricoid Cartilage - diagnostic imaging
difficult
Emergencies
Emergency Service, Hospital
Female
Humans
Identification
Infant
Intubation - methods
Male
Medical personnel
Membranes
Neck - anatomy & histology
Neck - diagnostic imaging
neonate
Palpation
Pediatrics
Prospective Studies
techniques
Thyroid Cartilage - anatomy & histology
Thyroid Cartilage - diagnostic imaging
Ultrasonography, Interventional
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Summary:Background Emergency front of neck access in a “can't intubate can't oxygenate” scenario in pediatrics is rare. Ideally airway rescue would involve the presence of an ear, nose, and throat surgeon. If unavailable however, responsibility lies with the anesthesiologist and accurate identification of anterior neck structures is essential for success. Aim We assessed anesthesiologists’ accuracy in identification of the pediatric cricothyroid membrane by digital palpation in three predefined age groups (37 weeks to
ISSN:1155-5645
1460-9592
DOI:10.1111/pan.13773