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i am aware of ten cases of crocothyrotomy done in the emergency department
in patients from 2 years of age to 10 years of age.
 
                                                                           a
vertical incision was made in all cases to expose the thyroid and
cartilage.incisions were made in the cruco thyroid membrane and endotraccial
 tubes were inserted and the patients ventilated.causes of repiratory arrest
and/or cardiac arrest in these cases included trauma,epiglotitis and foreign
body.4 children survived who had cardiac activity on arrival.the other 6
patients had surgical airways established quickly but cardiac activity could
not be restored.                i would support formal training for all
emergency physicians and pediatricians in the skill of pediatric
cricothyrotomy.having this skill would allow for early and effective
surgical airway management for children with upper airway obstruction who do
not respond to standard basic life and advanced basic life support
procedures.does anyone have any cases and/or opinions on providing the skill
of cricothyrotomy to emergency or pediatric physicians who care for those
under 10 years of age.
 
       thanks,
 
                                                  dr.wayne longmore
michael costello
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