Scoring system to predict the depth of cricothyroid membrane.
Research type
Research Study
Full title
Proposal for a scoring system to predict the depth of cricothyroid membrane by correlating airway assessment parameters to the depth of cricothyroid membrane.
IRAS ID
247781
Contact name
Cyprian Mendonca
Contact email
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
During all general anaesthetics, after putting the patient off to sleep a breathing tube placed either in the oral cavity or in the wind pipe. The main purpose of this is to deliver oxygen to the lungs. It is important that anaesthetist performs a thorough assessment of airway before inducing general anaesthesia. In a very rare situation, despite of thorough airway assessment, one may completely fail to place the breathing tube and all measures giving oxygen may fail. This situation is known as a ‘can’t intubate can’t oxygenate’ situation (CICO). It is an emergency life threatening situation, as the patient is anaesthetised, paralysed and not able breathe oxygen. In such a situation, the anaesthetist needs to give oxygen by assessing the windpipe directly through the front of neck (this is known as Front Of Neck Access [FONA]. This involves a cut in the neck at a space between the thyroid cartilage (adam’s apple) and the cricoid cartilage, an area known as the cricothyroid membrane just at the beginning of wind pipe. A plastic tube is then inserted into this space through to the windpipe and the lungs can be oxygenated. If the cricothyroid membrane and wind pipe is very deep, then it is difficult to feel, then the Front of Neck Access procedure also becomes difficult. Therefore, it is important to know the depth of cricothyroid membrane (windpipe).
This study aims to use features of routine airway assessment and the depth of windpipe as measured using an ultrasound scan of the neck to create a scoring system that predicts the depth of the windpipe. This scoring system could allow the anaesthetist to anticipate if a FONA will be difficult, and therefore can be more prepared to take more specialised measures if an emergency CICO situation develops.REC name
South Central - Berkshire Research Ethics Committee
REC reference
18/SC/0418
Date of REC Opinion
26 Jul 2018
REC opinion
Favourable Opinion