Let me start off by saying that I am not a doctor, I have no pressional medical training, and I'm not going to be held responsible for any injuries, deaths, lawsuits, or any other negative repercussions that occur if you should attempt to perform this procedure. It is in fact illegal to perform this procedure without a medical license, so be willing to face the consequences if you try it, even if all goes well. This should be a last resort in an emergency situation where the victim will die without immediate attention, as it is a very dangerous operation.

Now, the interesting part. A cricothyroidotomy is a medical procedure that creates an emergency airway for a patient to breathe through. It is very similar to a tracheotomy, but is easier to perform, especially in an emergency situation. One could perform this procedure in a situation where the patient is unable to breathe due to a blocked airway, an allergic reation to a plant, food, or insect bite or sting, severe facial damage, or any other host of afflictions.

I've broken down the procedure into several basic, simplified steps.

  1. Absolute first thing to do: call the paramedics and police, since they can do this a lot better than you. Chances are, however, you're doing this yourself because you can't reach the paramedics or police. Next, do whatever you can to sterilize your hands, tools, and the front of the patient's neck. Locate the thyroid and cricoid cartiledge on the front of the neck. The thyroid cartiledge is the thick ring of tissue commonly called the Adam's apple, and has a "V" shaped notch in the top of it. The cricoid cartiledge is another, smaller, ring of cartiledge located directly below the thyroid cartiledge and is separated from it by a small, horizontal gap. It's a lot easier to find these on yourself when you have a spare moment than to try to locate them on someone else in an emergency situation. In fact, do so right now. Done? Read the next step.
  2. With a scalpel, or the sharpest tool available if a scalpel isn't available, make a horizontal incision in the skin directly in front of the gap between the cricoid and thyroid cartiledge. At this point, the patient is going to start bleeding. This is inevitable, unless the person is already dead, in which case you should probably just leave their body alone. Have a sterile, or at least clean, cloth or bandage at the ready to help absorb the blood. Pull back the skin to expose the cartiledge. Right now, the only thing separating the inside of the airway and the outside world is a thin membrane and a ligament that connects the cricoid and thyroid cartiledge.
  3. With your scalpel, make another horizontal incision, this one through the membrane between the cricoid and thyroid cartiledge. Take great care not to puncture the back of the airway, or else the person is in a whole world of trouble that can't be fixed outside of an emergency room. The airway is now breached, and you have to keep the incision open. Do this by inserting a piece of sterile hose, tubing, or anything else similar to that into the airway. One thing that works well that you can find in most locations is the tube from a ballpoint pen. Although it's not sterile, it's going to keep the person from suffocating. Be careful not to jam the tube into the back of the persons throat, as that will cause further damage. That's it, and the only thing left to do is stop the blood flow from the incision and keep it clean until you can get the person to a hospital. If the patient is going to have the tube in place for an extended period of time, it would be advisable to cover the end of the tube with something like cheesecloth to prevent foreign debris, insects, or anything else from getting inhaled.

There you have it. How to perform an effective, albeit rudimentary, emergency cricothyroidotomy. Again, don't take this as sound medical advice, but rather a very basic "how to" that you may consider using in an emergency situation where someone's life is at stake. I'm not going to be responsible if you accidentally kill someone.

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