Neck Position and Ultrasound Landmark of Cricothyroid Membrane

NCT04124770 | Completed

• 1 other identifier: H18-01601
• Study Type: observational
• Target: 58
• Locations: 1 country
• Sites: 1

Brief Summary

Cricothyroid membrane (CTM) localization is a critical step prior to emergent surgical airway access. Ultrasound-guided localization of the CTM on the skin of the neck had been suggested prior to induction of general anesthesia so that a marked entry point can be used to quickly establish emergent front of neck access if required. In this prospective observational study, the investigators aim to determine the potential for migration of the CTM markings in the sagittal plane during neck repositioning.

Conditions

Cricothyroid Membrane; Ultrasound; Airway; Cricothyroidotomy

Outcome Measures

Primary Outcomes (1)

• Cricothyroid membrane movement measured with ultrasound

  The primary outcome was the distance measured from superior border of the cricoid cartilage to the sternal notch in the sagittal plane between the three neck positions

  14 months

Secondary Outcomes (1)

• Directionality of cricothyroid membrane movement measured by ultrasound

  14 months

Interventions

Movement OTHER

Re-positioning of neck

Eligibility Criteria

• Age: 19 Years - 90 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Adult volunteers over age 19

You may qualify if:

• Patients aged between 19 and 90
• Scheduled for elective surgeries

You may not qualify if:

• history of cricothyrotomy
• history of tracheostomy
• history of thyroidectomy
• history of plastic surgery or neck skin flaps
• history of neck lymph node dissections
• history of open carotid endarterectomy
• history of cervical instrumentation
• history of neck deformities (acquired or congenital)
• history of allergic reactions to adhesive tapes.

Sponsors & Collaborators

• University of British Columbia: lead

Study Sites (1)

St Paul's Hospital

Vancouver, British Columbia, V6Z 1Y6, Canada

Location

Related Publications (10)

• Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, O'Sullivan EP, Woodall NM, Ahmad I; Difficult Airway Society intubation guidelines working group. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015 Dec;115(6):827-48. doi: 10.1093/bja/aev371. Epub 2015 Nov 10.

  PMID: 26556848 BACKGROUND

• Law JA, Broemling N, Cooper RM, Drolet P, Duggan LV, Griesdale DE, Hung OR, Jones PM, Kovacs G, Massey S, Morris IR, Mullen T, Murphy MF, Preston R, Naik VN, Scott J, Stacey S, Turkstra TP, Wong DT; Canadian Airway Focus Group. The difficult airway with recommendations for management--part 2--the anticipated difficult airway. Can J Anaesth. 2013 Nov;60(11):1119-38. doi: 10.1007/s12630-013-0020-x. Epub 2013 Oct 17.

  PMID: 24132408 BACKGROUND

• Aslani A, Ng SC, Hurley M, McCarthy KF, McNicholas M, McCaul CL. Accuracy of identification of the cricothyroid membrane in female subjects using palpation: an observational study. Anesth Analg. 2012 May;114(5):987-92. doi: 10.1213/ANE.0b013e31824970ba. Epub 2012 Feb 24.

  PMID: 22366848 BACKGROUND

• Lamb A, Zhang J, Hung O, et al. Exactitude du repérage de la membrane cricothyroïdienne par des stagiaires et des patrons en anesthésie dans un établissement canadien. Can J Anesth. 2015. doi:10.1007/s12630-015-0326-y.

  BACKGROUND

• Katz JA. 4th National Audit Project of the Royal College of Anaesthetists and The Difficult Airway Society. Anesthesiology. 2012. doi:10.1097/ALN.0b013e31823cf122.

  BACKGROUND

• Elliott DS, Baker PA, Scott MR, Birch CW, Thompson JM. Accuracy of surface landmark identification for cannula cricothyroidotomy. Anaesthesia. 2010 Sep;65(9):889-94. doi: 10.1111/j.1365-2044.2010.06425.x.

  PMID: 20645953 BACKGROUND

• Bair AE, Chima R. The inaccuracy of using landmark techniques for cricothyroid membrane identification: a comparison of three techniques. Acad Emerg Med. 2015 Aug;22(8):908-14. doi: 10.1111/acem.12732. Epub 2015 Jul 21.

  PMID: 26198864 BACKGROUND

• Cook TM, Woodall N, Frerk C; Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011 May;106(5):617-31. doi: 10.1093/bja/aer058. Epub 2011 Mar 29.

  PMID: 21447488 BACKGROUND

• Kristensen MS, Teoh WH, Rudolph SS, Hesselfeldt R, Borglum J, Tvede MF. A randomised cross-over comparison of the transverse and longitudinal techniques for ultrasound-guided identification of the cricothyroid membrane in morbidly obese subjects. Anaesthesia. 2016 Jun;71(6):675-83. doi: 10.1111/anae.13465. Epub 2016 Apr 2.

  PMID: 27037981 BACKGROUND

• Mallin M, Curtis K, Dawson M, Ockerse P, Ahern M. Accuracy of ultrasound-guided marking of the cricothyroid membrane before simulated failed intubation. Am J Emerg Med. 2014 Jan;32(1):61-3. doi: 10.1016/j.ajem.2013.07.004.

  PMID: 24475485 BACKGROUND

MeSH Terms

Interventions

Movement

Intervention Hierarchy (Ancestors)

Physiological Phenomena; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical Assistant Professor, University of British Columbia

Study Record Dates

• First Submitted: October 10, 2019
• First Posted: October 11, 2019
• Study Start: November 9, 2018
• Primary Completion: October 9, 2019
• Study Completion: October 9, 2019
• Last Updated: October 18, 2019

Record last verified: 2019-10

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)