critical care medicine
How To Do a Percutaneous Cricothyrotomy
Relevant Anatomy for Percutaneous Cricothyrotomy
The cricothyroid membrane lies between the thyroid cartilage and the cricoid cartilage. The membrane is about 1 cm longitudinally and 2 to 3 cm transversely. Tracheal cartilages extend caudally from the cricoid cartilage to the sternal notch. The area around the cricothyroid membrane is rich with blood vessels (superior thyroid arteries and the relatively uncommon variant thyroid ima arteries). The patient lies supine with the neck extended. After sterile preparation, the larynx is grasped with one hand while a blade is used to incise the skin, subcutaneous tissue, and cricothyroid membrane precisely in the midline, accessing the trachea. A hollow tube is used to keep the airway open. 