Cricothyroidotomy:A. Should not be performed in children younger than 12 years
Patients in whom attempts at intubation have failed or are precluded from intubation due to extensive facial injuries require a surgical airway. Cricothyroidotomy (Pic below) and percutaneous transtracheal ventilation are preferred over tracheostomy in most emergency situations because of their simplicity and safety. One disadvantage of cricothyroidotomy is the inability to place a tube greater than 6 mm in diameter due to the limited aperture of the cricothyroid space. Cricothyroidotomy is also relatively contraindicated in patients younger than 12 years because of the risk of damage to the cricoid cartilage and the subsequent risk of subglottic stenosis.
A. Use of a tracheostomy hook sta bil izes the thyroid carti lage and facil itates tube insertion. B. A 6.0-endotracheal tu be is inserted after digital confirmation of airway access.