Accurate anatomical structure of cricothyroid membrane is a prerequisite for emergency airway management

We read the article Joseph O et al. [ ] with great interest. A can’t intubate can’t oxygenate (CICO) situation is life-threatening, and is one of the biggest challenges that emergency physicians don’t want to encounter ever.The crisis need to be rapidly resolved by Emergency Front-of-neck access (FONA) in order to prevent hypoxic brain damage and death. It is well-known that the surgical airway has been the primary rescue route for this CICO situation. And the common methods included surgical and percutaneous cricothyrotomies [ ]. The Difficult Airway Society 2015 guidelines made the percutaneous cricothyrotomies first choice since its significant advantages [ ]. The percutaneous cricothyrotomy is the fastest and most reliable method of securing the airway in CICO situations especially in emergency department (ED). And mastering the anatomy of the cricothyroid membrane is the prerequisite for mastering this technique. Besides, the simulation teaching is essential to teach procedural skills and enhance confidence and transfer the skills to patients in can’t intubate can’t oxygenate (CICO) situation [ ].

Therefore, no matter which FONA technique will be chosen, it is imperative for the emergency physicians in ED to be familiar with the location and adjacent anatomy of cricothyroid membrane. All of the clinical personnel related to the airway management must receive regular training of FONA techniques in order to master necessary knowledge and technical skills, enhance implement confidence, as well as avoid skills declining [ ].To facilitate training, master the skills of the cricothyrotomy and master the anatomical structure and adjacent tissues of cricothyroid membrane in detail, with the help of some anatomists, Our team has arranged the adjacent anatomical structures of the cricothyroid membrane and the teaching materials and produced an instructional video of three Dimensions (3D) animation demonstrating ( Supplementary Videos 1–5 ). This video explains the adjacent structures of the cricothyroid membrane, including the important blood vessels around it ( Fig. 1 ), besides, it also elaborates the key points of the operation of the cricothyrotomy, which will be a great help for emergency physicians to master the technique detail. At the same time, this is also very helpful for surgical cricothyrotomy. Its effectiveness has been demonstrated in our own hospital emergency airway simulation training.

The following are the supplementary data related to this article.

Supplementary Video 1

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