There are several methods for performing a cricothyroidotomy, and CoTCCC research has helped identify which techniques have evidence to support their recommendation for use. Of note, a crossover study comparing the Cric-Key™ with the standard surgical procedure revealed that medics perform the procedure faster and with a lower failure rate using the Cric-Key. For that reason, it is considered the preferred device for cricothyroidotomies. The other two techniques that are CoTCCC-recommended include the bougie-aided open surgical technique and the standard open surgical technique.

Although there are considerations specific to each technique that you will learn about in the upcoming videos, there are some common considerations to highlight.

- The most common error is making the initial incision too small, thereby limiting the ability to clearly visualize the cricothyroid membrane.
- Identifying the landmarks properly is difficult and commonly leads to incorrect placement, including insertion into the trachea above the thyroid cartilage. This is compounded in large and muscular necks, and highlights the need to train frequently and practice landmark identification on multiple anatomical variants, if possible.
- Avoid “stabbing” when incising, as the scalpel can penetrate other structures if you are not careful.
- Once the membrane has been incised, Slide the integrated tracheal hook down the handle with your thumb until it enters the trachea and disengages from the handle, and Insert the Cric-Key with the endotracheal airway into the trachea .