A comparison of the incidence of cricothyrotomy in the deployed setting to the emergency department at a level 1 military trauma center: a descriptive analysis

Abstract

Airway management is a critical skill of emergency medicine physicians and prehospital providers. Airway compromise is the cause of 1.8% of battlefield deaths. Cricothyrotomy is a critical, lifesaving procedure. In this study, we conducted a retrospective descriptive analysis comparing the incidence of cricothyrotomies in the deployed setting versus the incidence in a military level 1 trauma center emergency department (ED) setting in San Antonio, Texas. The deployed/in-theater procedures were performed from September 2007 to July 2009. The ED procedures were performed from April 2010 to February 2012. Over these study periods, 28 cricothyrotomies were performed in the deployed setting against a backdrop of 11,492 trauma admissions compared to 4 cricothyrotomies performed during 2,741 trauma admissions in the ED setting. The per admission incidence of deployed cricothyrotomies was 0.24% versus an incidence of 0.15% in the ED (p=0.46). We conclude that this rare, lifesaving procedure is performed more often in the deployed setting than the ED, but this difference was not statistically significant.