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Research Article
Katarzyna Ciuk
Student’s Scientific Group at the Chair of Radiology, Jagiellonian University Medical College, Cracow
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Needle cricothyrotomy is a method of maintaining airways in emergency situations. One of identified factors that can make this procedure difficult to perform is ‘difficult neck anatomy’ or short obese neck. Due to the growing problem of obesity, we decided to estimate feasibility of needle cricothyrotomy by measuring the thickness of neck fat tissue in the population. Evaluation of this method is important because it is the only method that can be legally performed by paramedics in Poland. The aim of the study was to estimate feasibility of needle cricoidectomy by evaluating the percentage of population in which the thickness of subcutaneous fat tissue could potentially limit or complicate such a procedure.
Methods
In this retrospective study we reviewed CT scans of the neck from a database at the Department of Radiology, University Hospital in Cracow. 550 CT scans met inclusion criteria: age of patient over 18 years old, lack of any lesions altering anatomy of measured region of neck, the first CT scan of patient. 50.36% of patients were women. Median age was 61 years (range 18 – 93). The distance from the skin surface at the level of the lower edge of the thyroid cartilage to the cricothyroid ligament (surface - ligament distance, SLD) was measured. Statistical analysis of the data was performed using R software (R version 4.0.3).
Results
Median SLD was 1.41 (1.01 - 2.04). Subcutaneous fat tissue was thicker than maximal depth of application of cricothyrotomy (3cm) device in 31 patients (5.64%).
Conclusions
Performing needle cricothyrotomy may be limited in a considerable percentage of population (5.64%).
Keywords
cricothyrotomy, difficult neck anatomy, emergency airway management, needle cricothyrotomy, obesity
Figure 1
Figure 2
Figure 3
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
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Subject Areas
Critical Care & Emergency Medicine
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This preprint is under consideration at Scientific Reports. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Katarzyna Ciuk
Student’s Scientific Group at the Chair of Radiology, Jagiellonian University Medical College, Cracow
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 05 Nov, 2021
No community comments so far
Editor invited
On 03 Nov, 2021
Submission checks complete
On 03 Nov, 2021
First submitted
On 29 Oct, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Needle cricothyrotomy is a method of maintaining airways in emergency situations. One of identified factors that can make this procedure difficult to perform is ‘difficult neck anatomy’ or short obese neck. Due to the growing problem of obesity, we decided to estimate feasibility of needle cricothyrotomy by measuring the thickness of neck fat tissue in the population. Evaluation of this method is important because it is the only method that can be legally performed by paramedics in Poland. The aim of the study was to estimate feasibility of needle cricoidectomy by evaluating the percentage of population in which the thickness of subcutaneous fat tissue could potentially limit or complicate such a procedure.
Methods
In this retrospective study we reviewed CT scans of the neck from a database at the Department of Radiology, University Hospital in Cracow. 550 CT scans met inclusion criteria: age of patient over 18 years old, lack of any lesions altering anatomy of measured region of neck, the first CT scan of patient. 50.36% of patients were women. Median age was 61 years (range 18 – 93). The distance from the skin surface at the level of the lower edge of the thyroid cartilage to the cricothyroid ligament (surface - ligament distance, SLD) was measured. Statistical analysis of the data was performed using R software (R version 4.0.3).
Results
Median SLD was 1.41 (1.01 - 2.04). Subcutaneous fat tissue was thicker than maximal depth of application of cricothyrotomy (3cm) device in 31 patients (5.64%).
Conclusions
Performing needle cricothyrotomy may be limited in a considerable percentage of population (5.64%).
Figure 1
Figure 2
Figure 3
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
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