The accuracy of locating the cricothyroid membrane by palpation: an intergender study

Hdl Handle:
http://hdl.handle.net/10147/560368
Title:
The accuracy of locating the cricothyroid membrane by palpation: an intergender study
Authors:
Campbell, Mark; Shanahan, Hilary; Ash, Simon; Royds, Jonathan; Husarova, Viera; McCaul, Conan
Citation:
BMC Anesthesiology. 2014 Nov 22;14(1):108
Issue Date:
22-Nov-2014
URI:
http://dx.doi.org/10.1186/1471-2253-14-108; http://hdl.handle.net/10147/560368
Abstract:
Abstract Background The cricothyroid membrane (CTM) is the recommended site of access to the airway during cricothyrotomy to provide emergency oxygenation. We sought to compare the ability of physicians to correctly identify the CTM in male and female patients. Methods In a prospective observational study, anaesthetists were asked to locate the CTM by palpation which was then identified using ultrasound and the distance between the actual and estimated margin of the CTM was measured. Participants assessed the ease of CTM palpation using a visual analog scale. In a second series, the angulation of the posterior junction of the thyroid laminae was measured using ultrasound. Results 23 anaesthetists and 44 subjects participated. A total of 36 assessments were carried out in each gender. Incorrect identification of the CTM was more common in females (29/36 vs. 11/36, P < 0.001) and the distance from the CTM in the vertical plane was greater (11.0 [6.5–20.0] vs. 0.0 [0.0–10.0] mm, P < 0.001). In females distance from the CTM correlated positively with neck circumference (P = 0.005) and BMI (P = 0.00005) and negatively with subject height (P = 0.01). Posterior thyroid cartilage angulation was greater in females (118.6 ± 9.4° vs. 95.9 ± 12.9°, P = 0.02) and was lower in patients with correctly identified CTMs (100.0 ± 14.9° vs. 115.6 ± 15.9°, P = 0.02). VRS palpation correlated with decreased posterior thyroid cartilage angulation (P = 0.04). Conclusions CTM localisation is more difficult in female subjects irrespective of body habitus. It may be prudent to localize this structure by additional means (e.g. ultrasound) in advance of any airway manoeuvres or to modify the cricothyrotomy technique in the event that it is necessary in an emergency.
Language:
en
Keywords:
ANAESTHESIOLOGY; SURGERY

Full metadata record

DC FieldValue Language
dc.contributor.authorCampbell, Marken
dc.contributor.authorShanahan, Hilaryen
dc.contributor.authorAsh, Simonen
dc.contributor.authorRoyds, Jonathanen
dc.contributor.authorHusarova, Vieraen
dc.contributor.authorMcCaul, Conanen
dc.date.accessioned2015-07-14T11:58:34Zen
dc.date.available2015-07-14T11:58:34Zen
dc.date.issued2014-11-22en
dc.identifier.citationBMC Anesthesiology. 2014 Nov 22;14(1):108en
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2253-14-108en
dc.identifier.urihttp://hdl.handle.net/10147/560368en
dc.description.abstractAbstract Background The cricothyroid membrane (CTM) is the recommended site of access to the airway during cricothyrotomy to provide emergency oxygenation. We sought to compare the ability of physicians to correctly identify the CTM in male and female patients. Methods In a prospective observational study, anaesthetists were asked to locate the CTM by palpation which was then identified using ultrasound and the distance between the actual and estimated margin of the CTM was measured. Participants assessed the ease of CTM palpation using a visual analog scale. In a second series, the angulation of the posterior junction of the thyroid laminae was measured using ultrasound. Results 23 anaesthetists and 44 subjects participated. A total of 36 assessments were carried out in each gender. Incorrect identification of the CTM was more common in females (29/36 vs. 11/36, P < 0.001) and the distance from the CTM in the vertical plane was greater (11.0 [6.5–20.0] vs. 0.0 [0.0–10.0] mm, P < 0.001). In females distance from the CTM correlated positively with neck circumference (P = 0.005) and BMI (P = 0.00005) and negatively with subject height (P = 0.01). Posterior thyroid cartilage angulation was greater in females (118.6 ± 9.4° vs. 95.9 ± 12.9°, P = 0.02) and was lower in patients with correctly identified CTMs (100.0 ± 14.9° vs. 115.6 ± 15.9°, P = 0.02). VRS palpation correlated with decreased posterior thyroid cartilage angulation (P = 0.04). Conclusions CTM localisation is more difficult in female subjects irrespective of body habitus. It may be prudent to localize this structure by additional means (e.g. ultrasound) in advance of any airway manoeuvres or to modify the cricothyrotomy technique in the event that it is necessary in an emergency.-
dc.language.isoenen
dc.subjectANAESTHESIOLOGYen
dc.subjectSURGERYen
dc.titleThe accuracy of locating the cricothyroid membrane by palpation: an intergender studyen
dc.language.rfc3066en-
dc.rights.holderMark Campbell et al.; licensee BioMed Central Ltd.-
dc.description.statusPeer Reviewed-
dc.date.updated2014-12-05T12:04:07Z-
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