American Academy of Emergency Medicine

Improved Airway Management

Declining Rate of Cricothyrotomy in Trauma Patients with an Emergency Medicine Residency: Implications for Skills Training

Chang RS, Hamilton RJ, Carter WA

Acad Emerg Med. 1998;5:247-251.

This study tested the hypothesis that the rate of cricothyrotomy (surgical airway management similar to a tracheostomy) in trauma patients would decline with development of an Emergency Medicine residency-training program. A decreased rate of cricothyrotomy would indicate improved airway management sparing patients this potentially risky surgical procedure.

A retrospective chart review was conducted to determine the association of Emergency Medicine residency development and cricothyrotomy rate in adult trauma patient admissions. A ten year period was reviewed: July 1, 1985 through June 30, 1995. This period was divided into three phases: phase 1, before the inception of the Emergency Medicine residency (academic years 1985-1989); phase 2, initiation and establishment of the residency (academic years 1990-1992); and phase 3, full implementation of the Emergency Medicine residency (academic years 1993-1994).

Full implementation of the Emergency Medicine residency was associated with a decline in the cricothyrotomy rate, a marker for improved airway management.