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:
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Understand the indications for performing cricothyrotomy
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Describe the technique for performing a bougie-assisted cric
Take Home Points
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There is no replacement for preparation and practice, especially when it comes to performing a cric
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Bougie-assisted cric may be superior to the traditional knife-finger-tube method for non-surgeons and surgeons alike
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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
