title: Modified cricothyroidotomy in skill laboratory.
abstract: BACKGROUND
  Unsuccessful tracheal intubation is considered the most common cause of anesthesia death or brain damage. This study delineates our experience recommending modifications in the cricothyroidotomy technique.
  
  
  METHODS
  Thirty emergency medicine residents of participated in a study performed on the human simulator moulage in Skill Laboratory of Tabriz University of Medical Science. The cricothyroid membrane was punctured using a 16-gauge cannula. Later, J guide wire was advanced into trachea and standard 16-gauge intravenous cannula with a removable needle stylet withdrawn after the puncture being dilated by a dilator. Consequently, a cuffed tracheal tube (ID= 6) was introduced from the foramen.
  
  
  RESULTS
  From 30 residents, 18 residents performed cricothyroidotomy within 1 minute, 7 residents in 2 minutes and 5 residents failed to fulfill the procedure.
  
  
  CONCLUSIONS
  Several studies using cadavers and human simulators have demonstrated the pre-hospital feasibility of this technique. However, descriptions of clinical pre-hospital experience with percutaneous cricothyroidotomy are limited. This study shows that skill lab may help residents to acquire techniques required in management of difficult airway.
authors.affiliation: Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Soleimanpour
authors.forename: Samad
authors.initials: S
authors.lastname: Shams Vahdati
authors.forename: Ata
authors.initials: A
authors.lastname: Mahmoodpoor
authors.forename: Jafar
authors.initials: J
authors.lastname: Rahimi Panahi
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Afhami
authors.forename: Mahboub
authors.initials: M
authors.lastname: Pouraghaei
authors.forename: Samad Ej
authors.initials: SE
authors.lastname: Golzari
keywords: Difficult Airway Management; Percutaneous Cricothyroidotomy; Skill Laboratory