Emergency cricothyrotomy – a systematic review

Langvad, Sofie; Hyldmo, Per Kristian; Nakstad, Anders Rostrup; Vist, Gunn Elisabeth; Sandberg, Marten

doi:10.1186/1757-7241-21-43

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Table 4 Time consumption and success rates for the various emergency cricothyrotomy methods

From: Emergency cricothyrotomy – a systematic review

Method	Authors	Time		Median or mean?	Time (sec)	Failure limit (sec)	Variation		Rank in individ. study (time)	Participants		Success rate (%)
Method	Authors	Start	Stop	Median or mean?	Time (sec)	Failure limit (sec)	Measure	Value(s) (sec)	Rank in individ. study (time)	Success	Total	Success rate (%)
Arnd	Schaumann et al [39]	NR	T3	Mean	7.9	-	SD	11	1/2	82	93	88
			T5		98.7			58.3
			T8		108.6			59.5
	Eisenburger et al [45]	NR	T3	Mean	8	-	SD	7	1/2	12	20	60
			T5		30			28
			T8		100			46
Mlkr	Givens et al [30]	T4	T6	Mean	108.5	-	Range	[59.1-219.4]	2/2	20	20	100
	Metterlein et al [31]	T1	T5	Median	14	180	IQR	[11-16]	2/2	8	8	100
	Metterlein et al [31]	T5	T8		53		IQR	[52-55.8]		8	8	100
	Murphy et al [32]	T4	T8	Median	94	300	IQR	[77-132]	3/4	20	20	100
	Mariappa et al [34]	T3	T8	Median	50	-	IQR	[40-56.3]	2/3	20	20	100
	Benkhadra et al [35]	T5	T7	Median	71	300	95% CI	[60-92]	2/2	19	20	95
	Dimitriadis and Paoloni [36]	NR	T5	Median	28	210	IQR	[25-42]	4/4	17	23	74
			T6		123			[97-210]
			T8		126			[102-210]
	Schober et al [25]	T2	T8	Median	135	-	IQR	[116-307]	4/4	10	14	71
	Assmann et al [37]	T2	T8	Mean	42.3	-	SD	12.5	2/2	298	320	93
	Sulaiman et al [38]	T4	T8	Mean	87.2	-	SD	21.6	2/2	25	27	93
	Keane et al [41]	T5	T6	Mean	122.7	-	SD	48.4	2/2	20	22	91
	Vadodaria et al [42]	NR	NR	Median	38	300	Range	[30-54]	1/4	10	10	100
	Chan et al [46]	T5	T6	Mean	74.7	-	95% CI	[63.2-86.2]	2/2	14	15	93
Mini	Salah et al [33]	NR	T8	Mean	123	40	SD	46	4/4	0	21	0
	Dimitriadis and Paoloni [36]	NR	T5	Median	21	210	IQR	[16-30]	2/4	23	23	100
			T6		41			[36-48]
			T8		48			[40-55]
	Fikkers et al [40]	T4	T5	Mean	20.8	240	SD	8.8	2/2	17	20	85
	Fikkers et al [40]	T5	T8	Mean	149.7	240	SD	44.2	2/2	17	20	85
Airf	Helmstaedter et al [29]	T4	T7	Median	15.1	-	Range	[9.9-22.2]	4/7	20	20	100
Airf	Helmstaedter et al [29]	T4	T8		22.8		Range	[14.3-33.2]		20	20	100
Pati	Vadodaria et al [42]	NR	NR	Median	123	300	Range	[74-147]	4/4	8	10	80
Pert	Johnson et al [47]	NR	T8	Mean	148	-	SD	96	2/2	32	44	73
PCK	Helm et al [48]	T3	T6	Median	104	-	Range	[51-170]	2/2	10	15	67
	Helmstaedter et al [29]	T4	T7	Median	29.6	-	Range	[15.9-49.1]	7/7	20	20	100
	Helmstaedter et al [29]	T4	T8	Median	46.7	-	Range	[37-67.3]	7/7	20	20	100
	Murphy et al [32]	T4	T8	Median	181.5	300	IQR	[71-300]	4/4	12	20	60
	Mariappa et al [34]	T3	T8	Median	62.5	-	IQR	[41.3-150]	3/3	6	20	30
	Benkhadra et al [35]	T5	T7	Median	54	300	95% CI	[47-68]	1/2	16	20	80
	Assmann et al [37]	T2	T8	Mean	32.6	-	SD	14.9	1/2	304	320	95
QT1	Helmstaedter et al [29]	T4	T7	Median	13.3	-	Range	[5.5-34.2]	3/7	20	20	100
	Helmstaedter et al [29]	T4	T8		21.1		Range	[14.5-32.4]		20	20	100
	Givens et al [30]	T4	T6	Mean	23.9	-	Range	[8.5-63.6]	1/2	20	20	100
	Dimitriadis and Paoloni [36]	NR	T5	Median	24	210	IQR	[20-26]	2/4	23	23	100
			T6		40			[30-58]
			T8		48			[36-75]
	Schober et al [25]	T2	T8	Median	74	-	IQR	[48-145]	2/4	14	17	82
	Fikkers et al [40]	T4	T5	Mean	13.3	240	SD	6	1/2	19	20	95
	Fikkers et al [40]	T5	T8	Mean	47.9	240	SD	19.6	1/2	19	20	95
	Vadodaria et al [42]	NR	NR	Median	51	300	Range	[42-73]	2/4	10	10	100
QT2	Helmstaedter et al [29]	T4	T7	Median	16.9	-	Range	[10.5-36.2]	5/7	20	20	100
	Helmstaedter et al [29]	T4	T8		29.9		Range	[25-50.5]		20	20	100
	Metterlein et al [31]	T1	T5	Median	15	180	IQR	[12-16]	1/2	5	8	63
	Metterlein et al [31]	T5	T8		32		IQR	[29-33.5]		5	8	63
	Murphy et al [32]	T4	T8	Median	52	300	IQR	[38-77]	1/4	19	20	95
	Salah et al [33]	NR	T8	Mean	72	40	SD	47	3/4	9	21	43
Trqu	Helmstaedter et al [29]	T4	T7	Median	13.5	-	Range	[4.6-29.5]	2/7	20	20	100
Trqu	Helmstaedter et al [29]	T4	T8	Median	20.2	-	Range	[11.4-44.7]	2/7	20	20	100
Surg	Helm et al [48]	T3	T6	Median	95	-	Range	[43-165]	1/2	15	15	100
	Helmstaedter et al [29]	T4	T7	Median	23.4	-	Range	[16.2-53.2]	6/7	20	20	100
	Helmstaedter et al [29]	T4	T8	Median	35.4	-	Range	[30-61.8]	6/7	20	20	100
	Murphy et al [32]	T4	T8	Median	59	300	IQR	[41-127]	2/4	19	29	95
	Salah et al [33]	NR	T8	Mean	47	40	SD	16	1/4	14	21	67
	Mariappa et al [34]	T3	T8	Median	47	-	IQR	[41-55]	1/3	11	20	55
	Dimitriadis and Paoloni [36]	NR	T5	Median	15	210	IQR	[10-18]	1/4	23	23	100
			T6		32			[27-60]
			T8		34			[31-68]
	Schober et al [25]	T2	T8	Median	78	-	IQR	[54-135]	3/4	17	18	94
	Sulaiman et al [38]	T4	T8	Mean	44.3	-	SD	12.5	1/2	23	27	85
	Schaumann et al [39]	NR	T3	Mean	8.2	-	SD	9.7	2/2	79	94	84
			T5		119.2			61.2
			T8		136.6			66.3
	Keane et al [41]	T5	T6	Mean	29	-	SD	14.3	1/2	20	20	100
	Mutzbauer et al [43]	T2	T8	Median	73	-	IQR	[60-95]	2/2	9	10	90
	Davis et al [44]	NR	NR	Mean	51.6	-	95% CI	[44.2-59.0]	2/2	NR	NR	100
	Eisenburger et al [45]	NR	T3	Mean	7	-	SD	9	2/2	14	20	70
			T5		46			37
			T8		102			42
	Bair and Sakles [24]	T5	T8	Median	87	-	IQR	[58-116]	2/2	NR	NR	100
	Chan et al [46]	T5	T6	Mean	72.8	-	95% CI	[49.8-95.7]	1/2	13	15	87
	Holmes et al [21]	T5	T7	Mean	133.8	-	SD	93.4	2/2	30	32	94
	Holmes et al [21]	T5	T7	Median	114	-	IQR	[74-154]	2/2	30	32	94
	Johnson et al [47]	NR	T8	Mean	55	-	SD	35	1/2	38	44	86
RFST	Hill et al [22]	T2	T7	Median	149	300	IQR	[111-201]	2/2	8	11	73
	Holmes et al [21]	T5	T7	Mean	43.2	-	SD	44.6	1/2	28	32	88
	Holmes et al [21]	T5	T7	Median	32	-	IQR	[24-42]	1/2	28	32	88
BACT	Hill et al [22]	T2	T7	Median	67	300	IQR	[55-82]	1/2	9	10	90
Bair	Bair and Sakles [24]	T5	T8	Median	35	-	IQR	[24-46]	1/2	NR	NR	100
Bair	Davis et al [44]	NR	NR	Mean	33.3	-	95% CI	[29.8-36.8]	1/2	NR	NR	100
Csci	Schober et al [25]	T2	T8	Median	60	-	IQR	[42-82]	1/4	14	14	100
Need	Helmstaedter et al [29]	T4	T7	Median	10.6	-	Range	[5.5-23.1]	1/7	20	20	100
	Helmstaedter et al [29]	T4	T8	Median	19.2		Range	[10.8-27.8]		20	20	100
	Salah et al [33]	NR	T8	Mean	56	40	SD	35	2/4	7	21	33
	Mutzbauer et al [43]	T2	T8	Median	25	-	IQR	[20-30]	1/2	9	10	90
Trac	Vadodaria et al [42]	NR	NR	Median	102	300	Range	[75-116]	3/4	10	10	100

See text for an explanation of the abbreviations for the interventions. Time points used to measure the duration of the cricothyrotomies: T1: Decides to perform the intervention; T2: Starts to palpate the neck; T3: Identifies the cricothyroid space; T4: Unwraps the device; T5: Performs the first incision or puncture; T6: Inserts the device; T7: Secures the device; T8: Performs the first ventilation; NR: Not reported in paper. Methods employed to measure variability: SD: Standard deviation; IQR: Interquartile range; CI: Confidence interval. Failure limit: The attempt to establish an emergency cricothyrotomy is defined as a failure if this time limit is exceeded (“–“indicates that no time limit is defined).

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ISSN: 1757-7241

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