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Emergency airway puncture

Needle cricothyrotomy

Emergency airway puncture is the placement of a hollow needle into the airway in the throat. It is done to treat life-threatening choking.

Description

Emergency airway puncture is done in an emergency situation, when someone is choking and all other efforts to assist with breathing have failed.

  • A hollow needle or tube can be inserted into the throat, just below the Adam's apple (thyroid cartilage), into the airway. The needle passes between the thyroid cartilage and the cricoid cartilage.
  • In a hospital, before inserting the needle, a small cut may be made in the skin and the membrane between the thyroid and cricoid cartilages.

Why the Procedure Is Performed

A cricothyrotomy is an emergency procedure to relieve an airway obstruction until surgery can be done to place a breathing tube (tracheostomy).

If the airway blockage occurs with trauma to the head, neck, or spine, care must be taken to avoid further injury to the person.

Risks

Risks for this procedure include:

  • Injury to the voice box (larynx), thyroid gland, or esophagus

Risks for any surgery are:

  • Bleeding
  • Infection

Outlook (Prognosis)

How well the person does depends on the cause of the airway blockage and how quickly the person receives proper breathing support. Emergency airway puncture provides enough breathing support for only a very short period of time.

References

Cattano D, Piacentini AGG, Cavallone LF. Percutaneous emergency airway access. In: Hagberg CA, Artime CA, Aziz MF, eds. Hagberg and Benumof's Airway Management. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 27.

Herbert RB, Thomas D. Cricothyrotomy and percutaneous translaryngeal ventilation. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 6.

BACK TO TOP Text only

  • Emergency airway puncture - illustration

    An emergency airway puncture may be performed if all efforts to dislodge an object from the throat have failed. The procedure involves inserting a hollow needle into the throat just below the thyroid cartilage and should only be performed by a medical professional.

    Emergency airway puncture

    illustration

  • Cricoid cartilage - illustration

    The cricothyroid membrane, the softer area between the firmer and more prominent thyroid cartilage (Adam’s apple) and the smaller cricoid cartilage, is the portion of the throat used to insert a hollow needle to assist in breathing when other attempts have failed. This procedure is also known as an emergency airway puncture or cricothyrotomy.

    Cricoid cartilage

    illustration

  • Emergency airway puncture - series

    Presentation

  •  
  • Emergency airway puncture - illustration

    An emergency airway puncture may be performed if all efforts to dislodge an object from the throat have failed. The procedure involves inserting a hollow needle into the throat just below the thyroid cartilage and should only be performed by a medical professional.

    Emergency airway puncture

    illustration

  • Cricoid cartilage - illustration

    The cricothyroid membrane, the softer area between the firmer and more prominent thyroid cartilage (Adam’s apple) and the smaller cricoid cartilage, is the portion of the throat used to insert a hollow needle to assist in breathing when other attempts have failed. This procedure is also known as an emergency airway puncture or cricothyrotomy.

    Cricoid cartilage

    illustration

  • Emergency airway puncture - series

    Presentation

  •  
 

Review Date: 10/11/2018

Reviewed By: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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