Comparison of two ultrasound techniques
Research type
Research Study
Full title
Comparison of sagittal versus transverse ultrasound techniques in identifying the cricothyroid membrane in subjects with neck pathology.
IRAS ID
207296
Contact name
Bhavesh Patel
Contact email
Sponsor organisation
Royal Surrey County Hospital Foundation Trust
Duration of Study in the UK
0 years, 0 months, 3 days
Research summary
Background
The cricothyroid membrane (CTM) is located at the front of the neck which is a small area and is an alternative access to the lungs to provide oxygenation. During a ‘can’t intubate, can’t oxygenate’ situation, the front of neck airway access is advocated via the CTM which is associated with high failure rate if not performed correctly. The usual way of identifying the CTM is by digital palpation which is inaccurate. Studies have shown that ultrasound can increase the accuracy of identifying the CTM. Using the ultrasound is not an invasive technique but cricothyroidotomy is an invasive procedure associated with morbidity and mortality. In identifying the CTM accurately, the complication rate of performing cricothyroidotomy could be decreased. We have recently developed the Guildford Cricothyroid membrane Ultrasound Technique (G-CUT), which is a transverse ultrasound technique in identifying the CTM. This technique is accurate in identifying the CTM and also relatively easy and quick to perform. Hence, we propose conducting a prospective controlled observational study of comparing the time taken and accuracy to identify the CTM using the landmark technique and ultrasound techniques in subjects with neck pathology.Methodology
Training will be provided to the participants on using the ultrasound in identifying the CTM with both sagittal and transverse techniques. We require two 'study subjects' with neck pathology but otherwise medically stable. Participants will be randomized to both subjects in identifying the CTM first by digital palpation followed by the ultrasound techniques. Primary outcome is time taken in identifying the CTM successfully. Secondary outcomes include accuracy, user confidence, learning and preference.Expected outcomes
Ultrasound is accurate in identifying the CTM compared to digital palpation. In comparing the ultrasound techniques, the transverse technique is equally accurate but quicker to perform compared to sagittal technique. Participants will prefer the transverse technique as it easier to learn and perform.REC name
London - Central Research Ethics Committee
REC reference
16/LO/2068
Date of REC Opinion
6 Dec 2016
REC opinion
Favourable Opinion