A marking of the cricothyroid membrane with extended neck returns to correct position after neck manipulation and repositioning
| Autor: | Michael Kristensen, Simon Crawley, Wendy H. L. Teoh, Alexander Le Saint-Grant, Fraser Chisholm, James Bowness, Ourania Varsou, Andrew Dalton, Alasdair Taylor, B. McGuire |
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| Přispěvatelé: | University of St Andrews. School of Medicine, University of St Andrews. Education Division |
| Rok vydání: | 2020 |
| Předmět: |
RZ Other systems of medicine
Suprasternal notch medicine.medical_treatment Palpation Neck/diagnostic imaging Cricoid Cartilage 03 medical and health sciences 0302 clinical medicine RZ 030202 anesthesiology Cricoid cartilage Intubation Intratracheal medicine Humans Intubation Ultrasonography Orthodontics medicine.diagnostic_test business.industry DAS 030208 emergency & critical care medicine Neck manipulation General Medicine respiratory system Thyroid Cartilage/diagnostic imaging Position (obstetrics) Anesthesiology and Pain Medicine medicine.anatomical_structure Thyroid Cartilage Airway management Airway business Neck |
| Zdroj: | Acta Anaesthesiologica Scandinavica. 64:1422-1425 |
| ISSN: | 1399-6576 0001-5172 |
| DOI: | 10.1111/aas.13680 |
| Popis: | Background Emergency front of neck airway access by anaesthetists carries a high failure rate and it is recommended to identify the cricothyroid membrane before induction of anaesthesia in patients with a predicted difficult airway. We have investigated whether a marking of the cricothyroid membrane done in the extended neck position remains correct after the patient’s neck has been manipulated and subsequently repositioned Methods The subject was first placed in the extended head and neck position and had the cricothyroid membrane identified and marked with three methods, palpation, ‘laryngeal handshake’ and ultrasonography and the distance from the suprasternal notch to the cricothyroid membrane was measured. The subject then moved off the table and sat on a chair and subsequently returned to the extended neck position and examinations were repeated. Results Skin markings of all 11 subjects lay within the boundaries of the cricothyroid membrane when the subject was repositioned back to the extended neck position and the median difference between the two measurements of the distance from the suprasternal notch was 0 mm (range 0‐2 mm). Conclusion The cricothyroid membrane can be identified and marked with the subject in the extended neck position. Then the patient’s position can be changed as needed, for example to the ‘sniffing’ neck position for conventional intubation. If a front of neck airway access is required during subsequent airway management, the patient can be returned expediently to the extended‐neck position, and the marking of the centre of the membrane will still be in the correct place. Postprint |
| Databáze: | OpenAIRE |
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