The EM Educator Series: Mastering the Cricothyrotomy

Author: Alex Koyfman, MD (@EMHighAK) // Edited by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!

Case 1:

A 22-year-old male is brought in by EMS with severe facial trauma after a severe motorcycle crash. He appears to be in respiratory distress. Facial structures are unrecognizable.

Case 2:

A 53-year-old obese female presents with angioedema that has rapidly worsened over 4 hours. You are unable to view the posterior pharynx due to her enlarged tongue. Unfortunately, you do not have a flexible intubating endoscope.


  • What defines an anatomically or physiologically challenging airway?
  • When should you consider cricothyrotomy?
  • When is cricothyrotomy potentially your first option for airway intervention?
  • What is the relevant anatomy, what equipment is needed, and how do you perform a cricothyrotomy?
  • Are there any contraindications to cricothyrotomy?
  • What complications may occur with cricothyrotomy?


Suggested Resources:

For more on cricothyrotomy, see this great piece from Dr. Katy Hanson at

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