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November 4, 1974

A New Instrument for Emergency Cricothyrotomy

Author Affiliations

New Orleans

JAMA. 1974;230(5):669. doi:10.1001/jama.1974.03240050017004

To the Editor.—  Commercially available cricothyrotomes have certain deficiencies—either the airway lumen is too small or there is an inadequate indication of depth and angle of penetration. Furthermore, for the nonsurgeon, locating and cutting through the cricothyroid membrane can be a most difficult and risky procedure (when the skin over the membrane is tautened to facilitate cutting, the anatomical landmarks are lost and the underlying structures shift).This new instrument was designed to exploit the fact that it is a simple matter to locate anatomical structures with a fine needle (Figure). If you can perform venipuncture, you can put a needle through cricothyroid membrane. Little damage is done and more than one pass is permissible. The needle-knife assembly is built around a 23-gauge needle. It is mounted on a specially modified syringe and, without having to distort the neck, one can easily locate the cricothyroid space and pierce the cricothyroid