title: Emergency cricothyrotomy in infants--evaluation of a novel device in an animal model.
abstract: BACKGROUND
  According to different algorithms of airway management, emergency cricothyrotomy is the final step in managing an otherwise not accessible airway. As an alternative to an open surgical procedure, minimally invasive approaches exist. Quicktrach baby™ is a commercially available set for a minimal invasive cricothyrotomy in infants. The set consists of a plastic cannula over a metal needle for direct placement in the trachea. So far, this device has not been evaluated for its intended use.
  
  
  OBJECTIVE
  We hypothesize that Quicktrach baby™ allows the establishment of an emergency airway. The aim was to prove that the device is easy to handle and the cricothyrotomy fast to perform.
  
  
  METHODS
  After approval of the local ethics committee, the study was performed on the cadavers of 10 adult rabbits. Cricothyrotomy was performed with Quicktrach baby™. Successful placement, performance time, and complication rate were documented. Possible ventilation with a breathing bag was evaluated. Data are reported as mean and interquartile range.
  
  
  RESULTS
  Successful placement of Quicktrach baby™ was possible in all attempts. The placement took 31 [23-43] s. In two cases, a fracture of the cricoid's cartilage was seen. In one animal, damage to the posterior wall mucosa was observed. In all cases, sufficient ventilation was possible.
  
  
  CONCLUSIONS
  Quicktrach™ baby proved to be a reliable technique. In the animal model, it is easy and fast to perform. Only a few minor complications occurred. Sufficient ventilation was possible in all attempts.
authors.affiliation: Department of Anaesthesiology, University Hospital Regensburg, Regensburg, Germany. tom.metterlein@gmx.net
authors.forename: T
authors.initials: T
authors.lastname: Metterlein
authors.forename: M
authors.initials: M
authors.lastname: Frommer
authors.forename: P
authors.initials: P
authors.lastname: Kwok
authors.forename: S
authors.initials: S
authors.lastname: Lyer
authors.forename: B M
authors.initials: BM
authors.lastname: Graf
authors.forename: B
authors.initials: B
authors.lastname: Sinner
mesh_terms: D058109:Airway Management / Q000295:instrumentation*; D000818:Animals; D057785:Catheters; D003413:Cricoid Cartilage / Q000601:surgery*; D004195:Disease Models, Animal; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007821:Laryngeal Muscles / Q000601:surgery*; D007830:Larynx / Q000601:surgery; D009339:Needles; D011817:Rabbits; D012121:Respiration, Artificial; D013957:Thyroid Cartilage / Q000601:surgery*; D014132:Trachea / Q000601:surgery