Laryngotomy (emergency)

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preferable to tracheostomy as the cricothyroid membrane is more superficial than the trachaea

needs suitable blade and tube (eg ball-point pen barrel)

lie patient face up with support under the shoulders

if possible, get someone to hold the patient's head on the midline, which greatly improves the chance of success

feel for the Adam's apple (thyroid cartilage) - the cricothyroid membrane lies immediately below this and above the cricoid cartilage

only extend the neck when ready to operate as the movement risks converting partial to total obstruction

make a horizontal incision in the cricothyroid membrane and when the blood bubbles, twist the blade and introduce any available tube such as ball-point pen barrel

one or more large bore cannulae may also be suitable

ref: H/B of Emergencies in Gen Pract 2e, N Lawrence et al

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Laryngotomy (emergency)

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