Trauma ICU Rounds – Cricothyrotomy Considerations with Scott Weingart

Originally posted on Trauma ICU Rounds on February 12, 2021 – Visit to listen to accompanying podcast. Follow Trauma ICU Rounds (@traumaicurounds) and Dr. Kim (@dennisyongkim) to learn more on simplifying trauma critical care together.


Dr. Scott Weingart joins us on Rounds to discuss a topic that’s of great interest to the both of us – surgical cricothyroidotomy. Tune in to hear how Scott’s approach to performing a cric has evolved over time and why “trauma surgeons are the worst people to learn crics from?!” From  3 strikes and your out to the use of bougies, this episode covers all things cric.

Also check out Episode 23 of Rounds “Surgical Cricothyroidotomy: How I Do It”. Even better go to: https://emcrit.org/emcrit/surgical-airway/ and review the FANTASTIC content that has been put together by Scott and his team at EMCrit.

Learning Objectives

By the end of the episode you should be able to:

  1. Understand the indications for performing cricothyrotomy

  2. Describe the technique for performing a bougie-assisted cric

Take Home Points

  • There is no replacement for preparation and practice, especially when it comes to performing a cric

  • Bougie-assisted cric may be superior to the traditional knife-finger-tube method for non-surgeons and surgeons alike

  • Surgeons are the worst (kidding!)

Time Stamps

00:12 Introduction

03:28 Trauma surgeons are the worst?!

04:42 Scott’s early experience

06:46 Dennis’ early experience

08:18 The Shock Trauma experience

09:07 Evolution of the cric technique in Scott’s hands

12:34 Trauma surgeons are the worst….again?!

15:23 Do as I say not as I do

16:42 Start with a vertical extensile incision!

17:42 The psychological stress index

18:37 Don’t think, FEEL!

19:16 Things are always easier when it’s not your fault!

23:07 A before C! Crics bleed but focus on securing the airway

24:29 No trach? No problem.

25:20 Bougies here, bougies there, bougies everywhere! Standardization is key

27:16 So the cric is in, now what?

30:09 Needle cric? No thanks!

36:23 Final thoughts on crics

37:24 Outro

Resources

www.emcrit.com/cric

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